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Brain Pathol. 2015 Jul;25(4):418-28. doi: 10.1111/bpa.12227. Epub 2014 Dec 31.

Prognostic Relevance of Histomolecular Classification of Diffuse Adult High-Grade Gliomas with Necrosis.

Author information

1
Service d'Anatomie Pathologique et de Neuropathologie, Hôpital de la Timone, APHM, Marseille, France.
2
INSERM, CRO2 UMR_S 911, Aix-Marseille Université, Marseille, France.
3
Département de Neuropathologie Raymond Escourolle, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.
4
Centre de Recherche de l'Institut du Cerveau et de la Moelle Épinière (CRICM), UMR 7225, Université Pierre et Marie Curie-Paris 6, Paris, France.
5
INSERM U1127, Paris, France.
6
Service d'Anatomie Pathologique et Histologie-Cytologie, Hôpital Rangueil, CHU Toulouse, Toulouse, France.
7
INSERM U1037, Centre de Recherche en Cancérologie de Toulouse, Université de Toulouse, Toulouse, France.
8
Centre de Pathologie et de Neuropathologie Est, Hospices Civils de Lyon, Bron, France.
9
Service de Neurologie 2-Mazarin, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.
10
Service d'Anatomie Pathologique, Hôpital Foch, Suresnes, France.
11
Service Anatomie Pathologique, Pôle Pathologie Biologique, CHU Lille, Lille, France.
12
Service de Pathologie-Neuropathologie, Hôpital Pellegrin, CHU Bordeaux, Bordeaux, France.
13
EA2406, Histologie et Pathologie Moléculaire des Tumeurs, Université Bordeaux Segalen, Bordeaux, France.
14
Service d'Anatomie et Cytologie Pathologique, Hôpital Lariboisière, AP-HP, Paris, France.
15
Laboratoire d'Anatomie Pathologique, Hôpital Central, CHU Nancy, Nancy, France.
16
Laboratoire de Pathologie, Hôpital Charles Nicolle, CHU Rouen, Rouen, France.
17
Service d'Anatomie et Cytologie Pathologiques, CHU Amiens, Amiens, France.
18
Service d'Anatomie Pathologique, Hôpital de la Côte de Nacre, CHU Caen, Caen, France.
19
GIP CYCERON, CERVOxy, UMR 6301 ISTCT, CNRS, Caen, France.
20
Service Anatomie Pathologique, Hôpital de la Cavale Blanche, CHU Brest, Brest, France.
21
Service Anatomie et Cytologie Pathologiques, Plateau Technique de Biologie G. Mack, CHU Dijon, Dijon, France.
22
Laboratoire d'Anatomie et Cytologie Pathologiques, Hôpital Robert Debré, CHU Reims, Reims, France.
23
Service Anatomie et Cytologie Pathologiques, Hôpital Jean Minjoz, CHU Besançon, Besançon, France.
24
Service Anatomie et Cytologie Pathologiques, Hôpital Bicêtre, AP-HP, Kremlin-Bicêtre, France.
25
Service d'Anatomie Pathologique B, Hôpital Laennec, CHU Nantes, Nantes, France.
26
Département Pathologie Cellulaire et Tissulaire, CHU Angers, Angers, France.
27
Laboratoire d'Anatomie et Cytologie Pathologiques, Hôpital Gui de Chaulliac, CHU Montpellier, Montpellier, France.
28
Service d'Anatomie Pathologique, Hôpital la Source, CHR Orléans, Orléans, France.
29
Laboratoire d'Anatomie et Cytologie Pathologiques, Hôpital Pasteur, CHU Nice, Nice, France.
30
Service d'Anatomie et Cytologie Pathologiques, Hôpital Nord, CHU Saint-Etienne, Saint-Etienne, France.
31
Service d'Anatomie et Cytologie Pathologiques, Hôpital Pontchaillou, CHU Rennes, Renens, France.
32
Service Anatomie Pathologique, Hôpitaux Civils de Colmar, Colmar, France.
33
Service Anatomie Pathologique, Hôpital Dupuytren, CHU Limoges, Limoges, France.
34
Service d'Anatomie Pathologique, Hôpital Hautepierre, CHU Strasbourg, Strasbourg, France.
35
Service Anatomie Pathologique, HIA Saint-Anne, Toulon, France.
36
Département de Neuropathologie, CH Sainte-Anne, Paris, France.
37
Service d'Anatomie et Cytologie Pathologiques, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, Clermont-Ferrand, France.
38
Laboratoire d'Anatomie et Cytologie Pathologiques, Hôpital la Milétrie, CHU Poitiers, Poitiers, France.
39
Service d'Anatomie et Cytologie Pathologique, Hôpital Beaujon, AP-HP, Clichy, France.
40
Laboratoire d'Anatomie et Cytologie Pathologiques des Feuillants, Toulouse, France.

Abstract

Diffuse adult high-grade gliomas (HGGs) with necrosis encompass anaplastic oligodendrogliomas (AOs) with necrosis (grade III), glioblastomas (GBM, grade IV) and glioblastomas with an oligodendroglial component (GBMO, grade IV). Here, we aimed to search for prognostic relevance of histological classification and molecular alterations of these tumors. About 210 patients were included (63 AO, 56 GBM and 91 GBMO). GBMO group was split into "anaplastic oligoastrocytoma (AOA) with necrosis grade IV/GBMO," restricted to tumors showing intermingled astrocytic and oligodendroglial component, and "GBM/GBMO" based on tumors presenting oligodendroglial foci and features of GBM. Genomic arrays, IDH1 R132H expression analyses and IDH direct sequencing were performed. 1p/19q co-deletion characterized AO, whereas no IDH1 R132H expression and intact 1p/19q characterized both GBM and GBM/GBMO. AOA with necrosis/GBMO mainly demonstrated IDH1 R132H expression and intact 1p/19q. Other IDH1 or IDH2 mutations were extremely rare. Both histological and molecular classifications were predictive of progression free survival (PFS) and overall survival (OS) (P < 10(-4) ). Diffuse adult HGGs with necrosis can be split into three histomolecular groups of prognostic relevance: 1p/19q co-deleted AO, IDH1 R132H-GBM and 1p/19q intact IDH1 R132H+ gliomas that might be classified as IDH1 R132H+ GBM. Because of histomolecular heterogeneity, we suggest to remove the name GBMO.

KEYWORDS:

1p/19q co-deletion; GBMO; IDH1 R132H immunoexpression; adult high-grade gliomas; necrosis

PMID:
25407774
DOI:
10.1111/bpa.12227
[Indexed for MEDLINE]

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