Immunohistochemical Classification of Primary and Secondary Glioblastomas

• Published in: Journal of pathology and translational medicine Vol. 47; no. 6; pp. 541 - 548
• Main Authors: Lee, Kyu Sang, Choe, Gheeyoung, Nam, Kyung Han, Seo, An Na, Yun, Sumi, Kim, Kyung Ju, Cho, Hwa Jin, Park, Sung Hye
• Format: Journal Article
• Language: English
• Published: Seoul Korean Society of Pathologists, Korean Society for Cytopathology 01.12.2013; 대한병리학회
• Subjects: Age; Classification; Deoxyribonucleic acid; DNA; DNA methylation; Evolution; Genes; Medical prognosis; Medical research; Mutation; Pathogenesis; Rodents; Studies; Tumors; 병리학
• ISSN: 2383-7837; 2383-7845

Background: Glioblastomas may develop de novo (primary glioblastomas, P-GBLs) or through progression from lower-grade astrocytomas (secondary glioblastomas, S-GBLs). The aim of this study was to compare the immunohistochemical classification of glioblastomas with clinically determined P-GBLs and S-GBLs to identify the best combination of antibodies for immunohistochemical classification. Methods: We evaluated the immunohistochemical expression of epidermal growth factor receptor (EGFR), p53, and isocitrate dehydrogenase 1 (IDH-1) in 150 glioblastoma cases. Results: According to clinical history, the glioblastomas analyzed in this study consisted of 146 P-GBLs and 4 S-GBLs. Immunohistochemical expression of EGFR, p53, and IDH-1 was observed in 62.6%, 49.3%, and 11.1%, respectively. Immunohistochemical profiles of EGFR(+)/ p53(-), IDH-1(-)/EGFR(+)/p53(-), and EGFR(-)/p53(+) were noted in 41.3%, 40.2%, and 28.7%, respectively. Expression of IDH-1 and EGFR(-)/p53(+) was positively correlated with young age. The typical immunohistochemical features of S-GBLs comprised IDH-1(+)/EGFR(-)/p53(+), and were noted in 3.6% of clinically P-GBLs. The combination of IDH-1(-) or EGFR(+) was the best set of immunohistochemical stains for identifying P-GBLs, whereas the combination of IDH-1(+) and EGFR(-) was best for identifying S-GBLs. Conclusions: We recommend a combination of IDH-1 and EGFR for immunohistochemical classification of glioblastomas. We expect our results to be useful for determining treatment strategies for glioblastoma patients. [PUBLICATION ABSTRACT]