Integrated Classification of Pediatric Medulloblastomas (Histologically and Genetically Defined) with Prognostication, using Immunohistochemical Markers

Badrinath, T (2020) Integrated Classification of Pediatric Medulloblastomas (Histologically and Genetically Defined) with Prognostication, using Immunohistochemical Markers. Masters thesis, Christian Medical College, Vellore.

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Abstract

INTRODUCTION: Medulloblastoma is the most common malignant brain tumour of childhood which comprises 35-40% of childhood brain tumours as reported by Packer [et. al.]. It is a primitive neural ectodermal tumour (PNET) consisting of small round blue cells arising in the posterior fossa. OBJECTIVES: To classify pediatric medulloblastomas based on histological and genetically defined criteria by WHO CNS, 2016 using immunohistochemical markers, β-catenin, GAB-1, YAP-1 and p53 and correlate with its outcome. METHODS: A cohort of 111 cases of pediatric medulloblastoma (0-18 years) from January 2009 to June 2019 were included in this study. A detailed review of the H&E stained slides and integration of histological and molecular subgrouping was with the help of four immunohistochemical markers, β-catenin, GAB-1, YAP-1 and P53. Data analysis was done using SPSS software and association between the categorical variables was done using a chi-square statistics/ Fisher exact test (P value of <0.05, significant). Survival analysis was done for recurrence. RESULTS: Pediatric MBs were seen predominantly in midline with median age of 8 years (M: F=2.5:1). Histology subgrouping, 70.3% classic, 13.5% D/N, 13.5% LC/A and 2.7% MBEN and based on IHC, 12.61% WNT, 23.42% SHH, 27% non-WNT/non-SHH subgroup. There were 36.93% discordant cases which cannot be classified into any of genetically defined subgroups by IHC, which needs further molecular assays for confirmation. Drop metastasis was seen in 19.8%. Shorter recurrence time seen in SHH subgroup. CONCLUSION: Utility of a panel of IHC markers β-catenin, GAB1 and YAP1 markers have proven to be economical, rapid and robust method for molecular subgrouping.

Item Type: Thesis (Masters)
Additional Information: 201713352
Uncontrolled Keywords: Integrated Classification, Pediatric Medulloblastomas, Prognostication, Immunohistochemical Markers.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jan 2021 17:54
Last Modified: 29 Jan 2021 17:54
URI: http://repository-tnmgrmu.ac.in/id/eprint/13430

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