Jul 30, 2015
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Essential Information About Glioma You Must Know

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Molecular Markers:

1p/19q co-deletion
EGFR amplificatio
p16 deletion

Overview

(A) Definition: Brain tumors that are derived from Glial cells.

(B) Incidence (India): A recent report on the cancer registry survey conducted by Indian Council for Medical Research on Glioma incidence in India revealed its effect in the following major cities: 5.8% – Mumbai, 6.7% – Bangalore, 3.5% – Chennai, 5.6% -Dibrugarh and 28.2% in Thiruvananthpuram.

(C) Nomenclature:

Named according to the type of the cell, they “mimic”:

  • Ependymoma
  • Astrocytoma (e.g. Glioblastoma Multiforme)
  • Oligodendroglioma (”pure Oligodendroglial tumors”)
  • Mixed Glioma (e.g. Oligoastrocytoma)

(D) Classification:

(D) Classification

Astrocytoma
Histopathological Grading (WHO 2007)

(A) Incidence:

3 per 100,000 persons/year
27%-43% (most common) of all gliomas

(B) WHO grading:

  • grade II (low grade)
    – Diffusely infiltrating Astrocytoma (DA)
    – approx. 8%
  • grade III
    – Anaplastic Astrocytoma (AA)
    – approx. 20%
  • grade IV
    – GlioBlastoma Multiforme (GBM)
    – approx. 70%

Oligodendroglioma
Histopathological Grading (WHO 2007)

(A) Incidence:

0.3-0.4 per 100,000 persons/year
4%-15% of all gliomas

(B) WHO grading:

  • grade II (low grade)
    – “well-differentiated Oligodendroglioma”
    – approx. 77%
  • grade III (high grade)
    -“more”malignant anaplastic oligodendroglioma”
    – approx. 23%

1p/19q Co-Deletion as Molecular Marker
Marker for Differential Diagnosis

Marker for Differential Diagnosis01

Marker for Differential Diagnosis02

DangerofMissclassification

“The histological distinction between Oligodendrogliomas and Astrocytomas is often difficult and
immunohistochemical analysis does not provide useful information for a differential diagnosis.”

* Molinari et al. Int J Mol Med. 2010

DangerofMissclassification2

  • 1p/19q Co-Deletion is preferentially associated with Oligodendroglial vs Astrocytic Neoplasms, which helps in avoiding tumor misclassification
  • AOs and AOAs with 19p/19q co-deletion show similar clinical Behavior

* Horbinski Semin Diagn Pathol. 2010

1p/19q Co-Deletion as Molecular Marker
Glioma

“At the present time, molecular testing is recommended for all Anaplastic Oligodendroglial Tumors.”

*odriguez and Giannini Semin Diagn Pathol. 2010

Survey of treatment recommendations for Anaplastic Oligodendroglioma.

*Abrey et al. Neuro-Oncology 2007

Reported molecular genetic testing by Tumor Type

  • Anaplastic Oligodendroglioma 95%
  • Mixed Glioma (Oligoastrocytoma) 92%
  • Anaplastic Astrocytoma 3%
  • Low-grade Oligodendroglioma 14%
  • Glioblastoma 7%

Evaluation Recommendation

1p-19q

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