CORRELATION OF ATRX EXPRESSION WITH HISTOMORPHOLOGICAL AND PROLIFERATION MARKERS IN DIFFUSELY INFILTRATING GLIOMAS

Joshi Vidushi, Ahuja Ankur, Deb Prabal, Singh Kanwaljeet, Gahlot Gaurav PS, Sharma Garima, Singh Beenu

Abstract


Background: The role of today’s pathologist extends beyond the traditional confines of diagnosis and includes prognostication as well as guiding the clinician in terms of selecting the appropriate therapeutic protocol. This can be achieved by the emergence of newer prognostic markers like ATRX and KI67 LI for diffusely infiltrating gliomas

 

Aims:     To establish the utility of ATRX and Ki67 LI using immunohistochemistry and their correlation with established histomorphological predictors of poor outcome in diffusely infiltrating gliomas of various histological grades

 

Study design: We carried out the present cross section observational study in thirty cases of diffuse infiltrating glial tumors

 

Subjects & methods: The histopathological features (cellularity, mitotic activity, vascular proliferation and necrosis) were compared with expression patterns of immunohistochemical profile of ATRX and Ki67

 

Statistical Analysis Used: The variables included in the statistical analysis were histomorphological subtypes of the tumour, the WHO grade, ATRX and Ki67 labelling index. All data was assessed using chi-square test. p value < 0.05 was considered significant

 

Results:  ATRX mutation is significantly associated with tumours of grade II, III of astrocytic lineage, including secondary GBMs, rare in primary GBMs and uncommon in paediatric GBMs and pure oligodendroglial tumours.  Ki67 being an indicator of proliferation activity of cancer cells, higher value predicts poorer prognosis. The index study did not show any statistically significant correlation between ATRX versus grades of tumor, MVP, necrosis, Ki67 L1 expression. Owing to constraint of duration of study period, we did not assess patient survival and its correlation with ATRX expression

Keywords


Central nervous system (CNS) tumors, Diffusely Infiltrating Gliomas, Astrocytoma, Oligodendroglioma, Glioblastoma Multiforme (GMB), ATRX, MIB-1 LI (Ki67)

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