The histological representativeness of glioblastoma tissue samples

Abstract

Background Glioblastomas (GBMs) are known for having a vastly heterogenous histopathology. Several studies have shown that GBMs can be histologically undergraded due to sampling errors of small tissue samples. We sought to explore to what extent histological features in GBMs are dependent on the amount of viable tissue on routine slides from both biopsied and resected tumors. Methods In 106 newly diagnosed GBM patients, we investigated associations between the presence or degree of 24 histopathological and two immunohistochemical features and the tissue amount on hematoxylin-eosin (HE) slides. The amount of viable tissue was semiquantitatively categorized as “sparse,” “medium,” or “substantial” for each case. Tissue amount was also assessed for associations with MRI volumetrics and the type of surgical procedure. Results About half (46%) of the assessed histological and immunohistochemical features were significantly associated with tissue amount. The significant features were less present or of a lesser degree when the tissue amount was smaller. Among the significant features were most of the features relevant for diffuse astrocytic tumor grading, i.e., small necroses, palisades, microvascular proliferation, atypia, mitotic count, and Ki-67/MIB-1 proliferative index (PI). Conclusion A substantial proportion of the assessed histological features were at risk of being underrepresented when the amount of viable tissue on HE slides was limited. Most of the grading features were dependent on tissue amount, which underlines the importance of considering sampling errors in diffuse astrocytic tumor grading. Our findings also highlight the importance of adequate tissue collection to increase the quality of diagnostics and histological research.

The Multifaceted Role of Extracellular Vesicles in Glioblastoma: microRNA Nanocarriers for Disease Progression and Gene Therapy

“…On CT or MRI scans, GBs appear as irregular lesions, usually presenting central necrosis and perilesional edema, and angiography reveals extremely abnormal vasculature [ 89 ]. The histopathological hallmarks of GB include necrosis, calcifications and microvascular proliferation [ 88 , 90 , 91 , 92 ]. In addition, histological analysis of GB revealed pleomorphic cells, hyperplasia of endothelial cells and pericytes, lymphocytic infiltration, hemorrhages, thrombosis, angiocentric structures, desmoplasia, anaplasia, high mitotic rates, etc.…”

“…In addition, histological analysis of GB revealed pleomorphic cells, hyperplasia of endothelial cells and pericytes, lymphocytic infiltration, hemorrhages, thrombosis, angiocentric structures, desmoplasia, anaplasia, high mitotic rates, etc. [ 75 , 88 , 91 , 92 ]. Usually, GBs consist of glial-like cells or cells with astrocytic features, but some tumors exhibit intratumoral heterogeneity and present an oligodendroglial–astrocytic phenotype [ 2 ].…”

ATX-101, a Peptide Targeting PCNA, Has Antitumor Efficacy Alone or in Combination with Radiotherapy in Murine Models of Human Glioblastoma

“…Progeny cells consequently establish a hierarchical organization of stem cells, transient amplifying cells, and terminally differentiated cells. Glioma-initiating cells (GICs) showing a glioma stem cell (GSC) phenotype [ 22 , 23 ] colonize tumor areas with elevated hypoxia and “palisading necrosis” [ 24 , 25 ]. Residual infiltrating GICs result in less sensitivity to therapies and consequently GBM recurrence [ 26 , 27 ].…”

Visualizing surface marker expression and intratumoral heterogeneity with SERRS-NPs imaging

“…tumors, and sample only a subset of the tumor's overall composition. In addition, a significant proportion of histologically assessed GBMs samples are at risk of being under-graded [25] and the evaluation of the HER2 expression in breast cancers is often subject to equivocal results [26], which may complicate treatment decisions and negatively impact prognosis.…”

“…Considering the limitations of biopsies [25][26][27][28][29], it is imperative to develop molecular imaging methods that can serve as a minimally invasive alternative with the capacity to visualize the tumor's entire landscape over time. The relevance of these methods is further spotlighted as new molecular targets emerge, offering personalized treatment options.…”