| 1 | Unique case of oligoastrocytoma with recurrence and grade progression:Exhibiting differential expression of high mobility group-A1 and human telomerase reverse transcriptase显示文摘Mixed gliomas, primarily oligoastrocytomas, account for about 5%-10% of all gliomas. Distinguishing oligoastrocytoma based on histological features alone has limitations in predicting the exact biological behavior, necessitating ancillary markers for greater specificity. In this case report, human telomerase reverse transcriptase(hT ERT) and high mobility group-A1(HMGA1); markers of proliferation and stemness, have been quantitatively analyzed in formalin-fixed paraffin-embedded tissue samples of a 34 years old patient with oligoastrocytoma. Customized florescence-based immunohistochemistry protocol with enhanced sensitivity and specificity is used in the study. The patient presented with a history of generalized seizures and his magnetic resonance imaging scans revealed infiltrative ill-defined mass lesion with calcified foci within the left frontal white matter, suggestive of glioma. He was surgically treated at our center for four consecutive clinical events. Histopathologically, the tumor was identified as oligoastrocytoma-grade Ⅱ followed by two recurrence events and final progression to grade Ⅲ. Overall survival of the patient without adjuvant therapy was more than 9 years. Glial fibrillary acidic protein, p53, Ki-67, nuclear atypia index, pre-operative neutrophillymphocyte ratio, are the other parameters assessed. Findings suggest that hT ERT and HMGA1 are linked to tumor recurrence and progression. Established markers can assist in defining precise histopathological grade in conjuction with conventional markers in clinical setup. | Puneet Gandhi Richa Khare Kavita Niraj Nitin Garg Sandeep K Sorte Hanni Gulwani | 2016 | World Journal of Clinical Cases2016，4，9： | 2 |
| 2 | Novel molecular panel for evaluating systemic inflammation and survival in therapy naïve glioma patients显示文摘BACKGROUND Inflammation is crucial to tumor progression.A traumatic event at a specific site in the brain activates the signaling molecules,which triggers inflammation as the initial response within the tumor and its surroundings.The educated immune cells and secreted proteins then initiate the inflammatory cascade leading to persistent chronic inflammation.Therefore,estimation of the circulating inflammatory indicators kynurenine(KYN),interleukin-6(IL-6),tissue-inhibitor of matrix-metalloproteinase-1 and human telomerase reverse transcriptase(hTERT)along with neutrophil-lymphocyte ratio(NLR)has prognostic value.AIM To assess the utility of chosen inflammatory marker panel in estimating systemic inflammation.METHODS The chosen markers were quantitatively evaluated in 90 naive,molecularly subtyped plasma samples of glioma.A correlation between the markers and confounders was assessed to establish their prognostication power.Follow-up on the levels of the indicators was done 3-mo post-surgery.To establish the validity of circulating KYN,it was also screened qualitatively by dot-immune-assay and by immunofluorescence-immunohistochemistry in tumor tissues.RESULTS Median values of circulating KYN,IL-6,hTERT,tissue-inhibitor of matrixmetalloproteinase-1 and NLR in isocitrate-dehydrogenase-mutant/wildtype and within the astrocytic sub-groups were estimated,which differed from controls,reaching statistical significance(P<0.0001).All markers negatively correlated with mortality(P<0.0001).Applying combination-statistics,the panel of KYN,IL-6,hTERT and NLR achieved higher sensitivity and specificity(>90%)than standalone markers,to define survival.The inflammatory panel could discriminate between WHO grades,and isocitrate-dehydrogenase-mutant/wildtype and define differential survival between astrocytic isocitrate-dehydrogenase-mutant/wildtype.Therefore,its assessment for precise disease prognosis is indicated.Association of KYN with NLR,IL-6 and hTERT was significant.Cox-regression described KYN,IL-6,NLR,and hTERT as good prognostic markers,independent of confounders.Multivariate linear-regression analysis confirmed the association of KYN and hTERT with inflammation marker IL-6.There was a concomitant significant decrease in their levels in a 3-mo follow-up.CONCLUSION The first evidence-based study of circulating-KYN in molecularly defined gliomas,wherein the tissue expression was found to be concomitant with plasma levels.A non-invasive model for assessing indicators of chronic systemic inflammation is proposed. | Puneet Gandhi Richa Shrivastava Nitin Garg Sandeep K Sorte | 2021 | World Journal of Clinical Oncology2021，12，10： | 2 |
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