Aggressiveness of Grade 4 Gliomas of Adults

Abstract

Grade 4 adult gliomas are IDH-mutant astrocytomas and IDH-wildtype glioblastomas. They have a very high mortality rate, with survival at 5 years not exceeding 5%. We aimed to conduct a clinical imaging and morphogenetic characterization of them, as well as to identify the main negative prognostic factors that give them such aggressiveness. We conducted a ten-year retrospective study. We followed the clinical, imaging, and morphogenetic aspects of the cases. We analyzed immunohistochemical markers (IDH1, Ki-67, and nestin) and FISH tests based on the CDKN2A gene. The obtained results were analyzed using SPSS Statistics with the appropriate parameters. The clinical aspects representing negative prognostic factors were represented by patients’ comorbidities: hypertension (HR = 1.776) and diabetes mellitus/hyperglycemia (HR = 2.159). The lesions were mostly supratentorial, and the temporal lobe was the most affected. The mean volume was 88.05 cm3 and produced a midline shift with an average of 8.52 mm. Subtotal surgical resection was a negative prognostic factor (HR = 1.877). The proliferative index did not influence survival rate, whereas CDKN2A gene mutations were shown to have a major impact on survival. We identified the main negative prognostic factors that support the aggressiveness of grade 4 gliomas: patient comorbidities, type of surgical resection, degree of cell differentiation, and CDKN2A gene mutations.

Evaluation of Microvascular Density in Glioblastomas in Relation to p53 and Ki67 Immunoexpression

“…In contrast to our results, in the literature, the number of IDH1 mutant glioblastomas varies between 22.91 and 38.5% [ 30 , 31 , 32 ]. In the study conducted by Deacu et al, the patients’ survival was not influenced by the presence or absence of the IDH1 mutation [ 33 ]. Additionally, there is still insufficient data regarding the relationship between the IDH1 mutation status of the tumor and tumor angiogenesis [ 34 ].…”

A multi-center performance assessment for automated histopathological classification and grading of glioma using whole slide images

“…First, the poor performance of A3 has addressed that there should be individual tasks for A3. Therefore, we propose to use IHC as a valuable additional source of information, 29 , 30 especially Ki67 for the model to learn mitosis. We planned to effectuate the conception based on an improved UNet structure to identify prime IHC parameters.…”

Clinical role of NDRG2-based methylation status on survival pattern of glioblastoma

“… 1 Due to the latest advances in genomic 2 and proteomic levels 3 the advantageous for controlling robust signatures and clinically appropriate molecular classifiers of GBM have now been emerged. 4 …”