Background The current World Health Organization (WHO) 2021 classification of human glioma is based on key molecular biomarkers to define neoplastic entities. This review further delineates mutant IDH (isocitrate dehydrogenase) from wild-type IDH disease, a necessity given the large survival gap between mutant IDH and wild-type IDH tumors. In Indonesia, there are currently few reports on the distribution and significance of these mutations. Therefore, this research aims to determine the relationship between IDH mutations, as well as clinicopathological and prognostic factors in patients with gliomas. Other immunohistochemical markers including ATRX (alpha-thalassemia/mental retardation, X-linked), Ki67 and GFAP (glial fibrillary acidic protein) expression were also evaluated. Methods Forty-two glioma samples were collected from patients who underwent surgery at Dr. Kariadi General Hospital in Semarang, Central Java, Indonesia. Fresh and paraffin-embedded, formalin-fixed tissue samples were removed and sectioned for hematoxylin and eosin staining, immunohistochemistry, and IDH analysis of mutation. Medical records were used to collect clinicopathological and survival data. Results IDH1 mutations were discovered in 32 (76,1%) patients, and those with IDH1 mutation had longer overall survival when corresponded to patients with IDH1-wild-type. Lower expression of Ki67 was discovered to be very associated with a better prognosis. Conclusion IDH1 mutations status showed a significant relationship with prognosis in patients with glioma. Meanwhile, other markers (ATRX, Ki67, and GFAP) did not correlate with the prognosis.
Background : High grade Gliomas (HGGs) (World Health Organization grade III and IV) are aggressive brain tumors with a poor prognosis. Serum concentrations of GFAP and EGFR are theoretically raised in glioma patients, especially primary HGGs Aim : To look at serum levels of GFAP and EGFR in patients with Gliomas (Low Grade and High-Grade Glioma) and see if they were related to clinical outcome, MRI parameter and pathological features. Method : Between 2020-2021, pre-operative blood samples were taken from 39 patients with radiologically diagnosed glioma who were performed for tumour excision. The time between blood collection and surgical resection was an average of 10 days. GFAP and EGFR serum were compared in glioma and non-glioma patients. Result : Glioma patients had average of serum GFAP 747.93 + 1349.49 pg/ml and average of Serum EGFR 9.25 + 3.17 ng/ml. Non glioma average of GFAP and EGFR respectively were 292.91 + 369.30 pg/ml and 7.81 + 3.38 ng/ml.From all variable, we performed normality test using the Saphiro-wilk normality test and all variable were no normally distribution with p<0.05 Conclusion : Circulating GFAP and EGFR are promising method for “supportive” methods for differentiate between glioma and non-glioma patients, especially high grade glioma
Introduction: Spinal tumors are rare lesions. The incidence of spinal tumors is about 0.5-2.5 cases per 100,000 population per year.1 Thirty percent of spinal tumors are located intradural. Twenty to thirty percent of intradural tumors are schwannoma and spinal neurofibroma.2 Surgery is the leading choice for schwannomas and neurofibromas that grow progressively or cause neurological deficits.2,3,4 Currently, minimally invasive surgery is developing rapidly, including minimally invasive surgery on spine surgery.Better outcomes are expected in endoscopic spine surgery compared to conventional spine surgery techniques.This paper aims to provide an overview of endoscopic procedures for the surgical removal of spinal tumors.Case description: A 59-year-old man presented paraplegia of both lower limbs. The patient complained difficulty walking for nine months before admitted to the hospital. The patient also complained of difficulty moving both of his legs, burning pain sensation, pain and numbness sensation that radiates from chest region to both of his toes, he felt that his chest was tied, and he complained hard to breathe when he feels pain. Complaints are getting worse until the patient was unable to walk. We found intra-dural extramedullary lesion from the MRI that was suspicious of a nerve cell sheath tumor. The patient underwent surgical treatment for tumor removal with an endoscopic technique, the cancer was complete. From the histopathology, the tumor was a neurofibroma tumor.Conclusion: Neurofibroma is one of the most frequently intradural extramedullary spinal tumors. Good imaging can guide the diagnosis and a good plan for manage patients with spinal tumors. Complete tumor resection provides a better prognosis in patients with neurofibromas. With endoscopic techniques, total spinal tumor removal surgery can be performed. The surgical procedure for spinal tumors using an endoscopic approach may be an option for spinal neurofibromas patients.
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