Prognostic Significance of PDL1 and P53 Expression in Low and High Grade Gliomas

Hemashree, P (2020) Prognostic Significance of PDL1 and P53 Expression in Low and High Grade Gliomas. Masters thesis, Madras Medical College, Chennai.

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Abstract

BACKGROUND: Glioma is the most common type of primary brain tumors (51.4%) in adults. After standard treatment regimen (surgical section, radiotherapy and chemotherapy), the average survival time remains merely around 14 months for glioblastoma (grade iv glioma). There is a need for better and safer treatment strategies for gliomas, the initiation of a greater number of successive clinical trials associated with immune checkpoint blockade along with further exploration into the mechanism of tumor immunity, would be warranted. AIMS AND OBJECTIVES: 1. To analyze the status of PDL1 & P53 expression in low and high grade gliomas. 2. To correlate the histomorphological features with immunohistochemical expression in relation to over all survival. 3. To compare level of expression with grade and survival of patients. 4. To evaluate the prognosis and recurrence of high grade gliomas. MATERIALS AND METHODS: This is a retrospective and prospective study conducted in Department of Neuropathology, Rajiv Gandhi Government General Hospital / Madras Medical College, Chennai for a period of two years from June 2017 to June 2019. During this period of study total 1264 cases were received for histopathologic examination in which 206 cases accounts for astrocytic and oligodendroglial tumors, out of these a total of 50 cases of gliomas were selected in all grades (20 cases of low grade glioma and 30 cases of high grade glioma). The expressions are correlated with clinicopathological parameters. RESULTS: In our study it is seen that PDL1 and p53 expression increases with grades of glioma and both positive cases correlates with poor survival rate, thus proving that these markers can be used to predict the behaviour of these tumours and thereby prognosis. Hence pdl1 /p53 may represent a promising biomarker that predicts disease progression in glioblastoma. CONCLUSION: ◈ Among the 50 cases followed up 22 cases were alive. ◈ In these 22 cases there is 6 cases of LGG and 16 cases of HGG. Our study shows that 8 cases were positive for both PDL1 and p53 with weak staining pattern, 3 cases were positive for p53 alone. ◈ From the data mentioned above we found that Negative Staining / Weak expression of either PDL1/P53 Favours Good Prognosis and Survival Rate. ◈ Among the 28 deceased cases, there is I case of LGG & 27 cases of HGG, Our study shows that, 11 cases were strongly positive for both PDL1&P53. 7 cases were positive for P 53 and 4 cases were positive for PDL1. ◈ This shows that combined expression of both PDL1 and P53 along with strong staining intensity favours the poor prognosis and reduced survival. ◈ PDL1 is a more reliable marker for predicting poor prognosis and survival as the more number of PDL1 positive cases had < 6 months survival rate, with a median survival period of 5 months. ◈ Despite considerable progress in treatment modalities, the prognosis and outcome remains dismal. In our study it is seen that PDL1 and P53 expression increases with grades of glioma and both positive cases correlates with poor survival rate, Thus proving that these markers can be used to predict the behaviour of these tumours and thereby prognosis. ◈ Hence, PDL1 may represent a promising biomarker that predicts disease progression in Glioblastoma. ◈ The improvement of PDL1 antibody based immunotherapy with other molecule - targeted anti-cancer drugs promises better survival in glioblastoma.

Item Type: Thesis (Masters)
Additional Information: 201713003
Uncontrolled Keywords: GLIOMA, PDL1, P53, PROGNOSIS.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jan 2021 15:13
Last Modified: 29 Jan 2021 15:13
URI: http://repository-tnmgrmu.ac.in/id/eprint/13393

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