小活检中分散的神经胶质瘤细胞的组织学鉴定可能具有挑战性,特别是在缺乏IDH1R132H突变或TP53改变的肿瘤中。我们假设免疫组织化学检测在神经胶质瘤中优先表达的蛋白质(EGFR,MEOX2,CD34)或胚胎发育过程中(SOX11,INSM1)可用于区分反应性神经胶质增生与神经胶质瘤。46个反应性胶质细胞的组织微阵列,81个胶质母细胞瘤,34IDH1突变型弥漫性神经胶质瘤,并分析了23例其他类型的胶质瘤。胶质肿瘤的EGFR阳性(p<0.001,χ2)明显更高(34.1%vs.0%),MEOX2(49.3%vs.2.3%),SOX11(70.5%与20.4%),和INSM1(65.4%与2.3%)。在94.3%(66/70)的胶质母细胞瘤中,观察到至少两种标志物的表达,而没有反应性神经胶质增生显示任何蛋白质的共表达。与IDH1突变肿瘤相比,胶质母细胞瘤的EGFR表达明显增高,MEOX2和CD34,并且显著降低SOX11的阳性。非弥漫性神经胶质瘤很少对所测试的五种标志物中的任何一种呈阳性。我们的结果表明,EGFR的免疫组织化学检测,MEOX2、SOX11和INSM1可用于在有限的组织学样本中检测胶质母细胞瘤细胞,特别是在组合使用时。
Histological identification of dispersed glioma cells in small biopsies can be challenging, especially in tumours lacking the IDH1 R132H mutation or alterations in TP53. We postulated that immunohistochemical detection of proteins expressed preferentially in gliomas (EGFR,
MEOX2, CD34) or during embryonal development (SOX11, INSM1) can be used to distinguish reactive gliosis from glioma. Tissue microarrays of 46 reactive glioses, 81 glioblastomas, 34 IDH1-mutant diffuse gliomas, and 23 gliomas of other types were analysed. Glial neoplasms were significantly more often (p < 0.001, χ2) positive for EGFR (34.1% vs. 0%),
MEOX2 (49.3% vs. 2.3%), SOX11 (70.5% vs. 20.4%), and INSM1 (65.4% vs. 2.3%). In 94.3% (66/70) of the glioblastomas, the expression of at least two markers was observed, while no reactive gliosis showed coexpression of any of the proteins. Compared to IDH1-mutant tumours, glioblastomas showed significantly higher expression of EGFR,
MEOX2, and CD34 and significantly lower positivity for SOX11. Non-diffuse gliomas were only rarely positive for any of the five markers tested. Our results indicate that immunohistochemical detection of EGFR,
MEOX2, SOX11, and INSM1 can be useful for detection of glioblastoma cells in limited histological samples, especially when used in combination.