ATRX, IDH1-R132H and Ki-67 immunohistochemistry as a classification scheme for astrocytic tumors

Jinquan Cai1,6,*, Chuanbao Zhang2,3,*, Wei Zhang2,3, Guangzhi Wang1,6, Kun Yao6,7, Zhiliang Wang3,6, Guanzhang Li2,6, Zenghui Qian2,6 Yongli Li1,6, Tao Jiang2,3,4,5,6, Chuanlu Jiang1,6

1Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, NanGang District, Harbin, Heilongjiang Province 150001, China

2Beijing Neurosurgical Institute, Capital Medical University, Dongcheng District, Beijing 100050, China

3Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing 100050, China

4Beijing Institute for Brain Disorders Brain Tumor Center, Dongcheng District, Beijing 100050, China

5China National Clinical Research Center for Neurological Diseases, Dongcheng District, Beijing 100050, China

6Chinese Glioma Cooperative Group (CGCG), Dongcheng District, Beijing 100050, China

7Department of Pathology, Sanbo Brain Hospital, Capital Medical University, Haidian District, Beijing 100093, China

*These authors have contributed equally to the work

Correspondence to:

Yongli Li, email: liyongli9999@aliyun.com

Chuanlu Jiang, email: jcl6688@163.com

Tao Jiang, email: taojiang1964@163.com

Keywords: ATRX, IDH-R132H, Ki-67, astrocytic tumors, progression

Received: May 10, 2016     Accepted: August 12, 2016     Published: September 06,2016


Recurrence and progression to higher grade lesions are key biological events and characteristic behaviors in the evolution process of glioma. Malignant astrocytic tumors such as glioblastoma (GBM) are the most lethal intracranial tumors. However, the clinical practicability and significance of molecular parameters for the diagnostic and prognostic prediction of astrocytic tumors is still limited. In this study, we detected ATRX, IDH1-R132H and Ki-67 by immunohistochemistry and observed the association of IDH1-R132H with ATRX and Ki-67 expression. There was a strong association between ATRX loss and IDH1-R132H (p<0.0001). However, Ki-67 high expression restricted in the tumors with IDH1-R132H negative (p=0.0129). Patients with IDH1-R132H positive or ATRX loss astrocytic tumors had a longer progressive-free survival (p<0.0001, p=0.0044, respectively). High Ki-67 expression was associated with shorter PFS in patients with astrocytic tumors (p=0.002). Then we characterized three prognostic subgroups of astrocytic tumors (referred to as A1, A2 and A3). The new model demonstrated a remarkable separation of the progression interval in the three molecular subgroups and the distribution of patients’ age in the A1-A2-A3 model was also significant different. This model will aid predicting the overall survival and progressive time of astrocytic tumors’ patients.

PII: 317