Histopathological study of Gliomas and Evaluation of IDH – 1 Expression in Glioblastoma by Immunohistochemistry

Niveditha, J (2020) Histopathological study of Gliomas and Evaluation of IDH – 1 Expression in Glioblastoma by Immunohistochemistry. Masters thesis, Madurai Medical College, Madurai.


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INTRODUCTION: The recent WHO 2016 CLASSIFICATION OF CNS TUMORS incorporates molecular parameters for classification of gliomas. • Accordingly, all diffusely infiltrating gliomas (Grades II –IV) have been grouped together based on histopathological assessment and IDH – (Isocitrate dehydrogenase) mutation status. • IDH mutant, IDH wildtype- diffuse gliomas & glioblastomas are among the few new entities included in this classification. • Utility of assessment of IDH mutation status: • To identify reactive gliosis from gliomas in difficult cases. • To differentiate infiltrating and non infiltrative gliomas in adults. • IDH mutant gliomas are associated with better prognosis. • Can provide ground for novel treatment strategies targeting IDH mutations. AIMS AND OBJECTIVES: 1. To study the frequency of occurrence of gliomas in specimens received from Government Rajaji hospital, Madurai to the Department of pathology, Madurai Medical College. 2. To study the incidence in relation to age and sex in gliomas. 3. To study the histopathological classification of gliomas. 4. To analyse the expression of immunohistochemical marker Isocitrate dehydrogenase (IDH -1) in glioblastomas – utility in identifying glioblastomas with better prognosis. BACKGROUND OF STUDY: • Histopathological study to morphologically classify gliomas and to know the incidence of the same in a population of different age and sex. • Immunohistochemical marker study with IDH-1(R132H) as an independent predictor of better prognosis in gliobastomas. • Place of study: Madurai Medical College. • Study design: Prospective study. • Sample size: 50. INCLUSION CRITERIA: • Biopsy specimens of space occupying lesions (SOL) of brain EXCLUSION CRITERIA: • Benign tumors. • Neoplastic lesions other than gliomas. SUMMARY: In the present prospective study of 96 cases of brain SOLs, the following results were obtained: • Out of the 96 cases, 92% were neoplastic lesions and 97% were primary brain tumors. • Gliomas comprised of 50 cases out of the 96 brain SOLs and were the commonest among the primary CNS tumors. • Of the non glial tumors, meningiomas were the commonest constituting 28.2%. • The commonest glioma was glioblastoma accounting for 42%. • The most common age group affected by gliomas was 40-59 years with an overall frequency of 46% and the glioblastomas was 50 -59 years accounting for 38.1%. • Males had a definite sex predilection for both gliomas overall and glioblastomas specifically, accounting for 62% and 71.4% respectively. • The commonest location of all gliomas and glioblastomas in specific was the frontal lobe. • Unusual sites of distribution of gliomas were – corpus callosum and cerebellum. • The analysis of IDH1mutation showed IDH wild type glioblastomas as the most predominant, comprising 71.4% of the glioblastomas. The results were statistically significant with a p value of 0.0327 (p<0.05). • The most common sex affected in IDH1 mutant glioblastomas was male and the most common age group was 50-59 years. The results were statistically significant with a p value of 0.0464(p<0.05). • IDH wild type glioblastomas accounted for 26.7% of the seventh decade patients. • Frontal lobe was the predilected site for IDH1 mutant glioblastomas. The results were statistically significant with a p value of 0.028. • The analysis of EGFR mutation in all IDH wild type glioblastomas showed 40% positivity.

Item Type: Thesis (Masters)
Additional Information: 201713101
Uncontrolled Keywords: Gliomas, IDH–1 Expression, Glioblastoma, Immunohistochemistry, Histopathological study.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jan 2021 16:14
Last Modified: 29 Jan 2021 16:14
URI: http://repository-tnmgrmu.ac.in/id/eprint/13403

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