Brain Neoplasms

脑肿瘤
  • 文章类型: Journal Article
    线粒体肽在胶质母细胞瘤扩散中的作用仍然知之甚少。在这项研究中,我们研究了颅内胶质母细胞瘤进展的潜在机制.我们的发现表明线粒体衍生的肽,humanin,通过整合素αV(ITGAV)-TGFβ(TGFβ)信号轴的瘤内激活,在增强胶质母细胞瘤的进展中起重要作用。在胶质母细胞瘤组织中,与相应的正常区域相比,humanin在肿瘤区域显示出显着的上调。利用多种体外药理学和遗传学方法,我们观察到人蛋白激活ITGAV通路,导致细胞附着和丝状伪足形成。该过程通过细胞内TGFβR信号激活来帮助附着的成胶质细胞瘤细胞的后续迁移和侵袭。此外,我们的体内原位胶质母细胞瘤模型为humanin的促肿瘤功能提供了进一步的支持.我们观察到在humanin治疗组中生存不良和侵袭性之间的相关性,与对照组相比,具有明显的肿瘤突起和诱导的血管生成。有趣的是,通过TGFBR1抑制剂的治疗,humanin对胶质母细胞瘤的体内作用显著降低.为了加强这些发现,公共数据库分析显示,ITGAV-TGFβR轴中的基因与胶质母细胞瘤患者的不良预后之间存在显著关联.这些结果共同强调了humanin是一种促肿瘤因子,使其成为治疗胶质母细胞瘤的有希望的生物学靶标。
    The role of mitochondria peptides in the spreading of glioblastoma remains poorly understood. In this study, we investigated the mechanism underlying intracranial glioblastoma progression. Our findings demonstrate that the mitochondria-derived peptide, humanin, plays a significant role in enhancing glioblastoma progression through the intratumoral activation of the integrin alpha V (ITGAV)-TGF beta (TGFβ) signaling axis. In glioblastoma tissues, humanin showed a significant upregulation in the tumor area compared to the corresponding normal region. Utilizing multiple in vitro pharmacological and genetic approaches, we observed that humanin activates the ITGAV pathway, leading to cellular attachment and filopodia formation. This process aids the subsequent migration and invasion of attached glioblastoma cells through intracellular TGFβR signaling activation. In addition, our in vivo orthotopic glioblastoma model provides further support for the pro-tumoral function of humanin. We observed a correlation between poor survival and aggressive invasiveness in the humanin-treated group, with noticeable tumor protrusions and induced angiogenesis compared to the control. Intriguingly, the in vivo effect of humanin on glioblastoma was significantly reduced by the treatment of TGFBR1 inhibitor. To strengthen these findings, public database analysis revealed a significant association between genes in the ITGAV-TGFβR axis and poor prognosis in glioblastoma patients. These results collectively highlight humanin as a pro-tumoral factor, making it a promising biological target for treating glioblastoma.
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  • 文章类型: Journal Article
    STING激动剂可以重新编程肿瘤微环境以诱导中枢神经系统内的免疫清除。使用多重序贯免疫荧光(SeqIF)和常春藤胶质母细胞瘤图谱,在骨髓群和血管周围间隙中发现STING表达。STING激动剂8803在胶质母细胞瘤的多种临床前模型中增加中位生存期,包括QPP8,一种免疫检查点阻断抗性模型,100%的小鼠被治愈。在治疗窗口期间的离体流式细胞术分析显示髓样肿瘤运输和活化的增加,同时增强CD8+T细胞和NK效应子应答。用8803重编程小胶质细胞治疗以表达共刺激CD80/CD86和iNOS,同时降低免疫抑制性CD206和精氨酸酶。在人源化小鼠中,肿瘤细胞STING被表观遗传学沉默,8803治疗活性得以维持,进一步证明骨髓依赖性和重编程。尽管与STAT3抑制剂的组合没有进一步增强STING激动剂活性,在免疫检查点阻断反应性神经胶质瘤模型中,在8803治疗中加入抗PD-1抗体可提高生存率.总之,8803作为单一疗法证明了显著的体内治疗活性,临床翻译值得考虑。
    STING agonists can reprogram the tumor microenvironment to induce immunological clearance within the central nervous system. Using multiplexed sequential immunofluorescence (SeqIF) and the Ivy Glioblastoma Atlas, STING expression was found in myeloid populations and in the perivascular space. The STING agonist 8803 increased median survival in multiple preclinical models of glioblastoma, including QPP8, an immune checkpoint blockade-resistant model, where 100% of mice were cured. Ex vivo flow cytometry profiling during the therapeutic window demonstrated increases in myeloid tumor trafficking and activation, alongside enhancement of CD8+ T cell and NK effector responses. Treatment with 8803 reprogrammed microglia to express costimulatory CD80/CD86 and iNOS, while decreasing immunosuppressive CD206 and arginase. In humanized mice, where tumor cell STING is epigenetically silenced, 8803 therapeutic activity was maintained, further attesting to myeloid dependency and reprogramming. Although the combination with a STAT3 inhibitor did not further enhance STING agonist activity, the addition of anti-PD-1 antibodies to 8803 treatment enhanced survival in an immune checkpoint blockade-responsive glioma model. In summary, 8803 as a monotherapy demonstrates marked in vivo therapeutic activity, meriting consideration for clinical translation.
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  • 文章类型: Journal Article
    尽管在92%的TP53突变癌症中发生了突变,p53同工型的突变如何影响它们的活性仍然是未知的.因此,探索突变对p53同工型活性的影响是至关重要的,尽管在p53领域尚未探索的领域。在这篇文章中,我们首次报道了突变的Δ133p53α特异性途径,该途径增加了IL4I1和IDO1的表达并激活了AHR,促进肿瘤的机制。因此,而WTΔ133p53α减少细胞凋亡以促进DNA修复,突变体R273H也减少细胞凋亡,但不能保持基因组的稳定性,增加突变积累和肿瘤向更具侵袭性表型的风险。此外,使用2D和3D球体培养,我们显示WTΔ133p53α减少细胞增殖,EMT,和入侵,而突变体Δ133p53αR273H增强了所有三个过程,证实了其致癌潜力,并强烈暗示了类似的体内活性。重要的是,对细胞生长和侵袭的影响与突变体全长p53α无关,表明这些活性由突变体Δ133p53αR273H积极携带。此外,WT和突变型Δ133p53α均以衰老诱导剂依赖性方式(替莫唑胺或辐射)降低细胞衰老,因为它们调节不同的衰老相关靶基因。因此,WTΔ133p53α挽救了替莫唑胺诱导的衰老,但不是辐射诱导的衰老,而突变体Δ133p53αR273H挽救了辐射诱导的衰老,但不是替莫唑胺诱导的衰老。最后,我们确定IL4I1,IDO1和AHR在GBM中显著高于低级别胶质瘤.重要的是,LGG和IL4I1在GBM中的所有三个基因的高表达与较差的患者生存率显着相关,证实该途径在胶质母细胞瘤中的临床相关性。这些数据表明,与WTΔ133p53α相比,R273H突变将其活性重新定向为致癌作用,并激活致癌IL4I1/IDO1/AHR途径,通过结合特异性调节Δ133p53α表达的药物和IDO1/Il4I1/AHR抑制剂,成为GBM中潜在的预后标志物和治疗靶标。
    Despite being mutated in 92% of TP53 mutant cancers, how mutations on p53 isoforms affect their activities remain largely unknown. Therefore, exploring the effect of mutations on p53 isoforms activities is a critical, albeit unexplored area in the p53 field. In this article, we report for the first time a mutant Δ133p53α-specific pathway which increases IL4I1 and IDO1 expression and activates AHR, a tumor-promoting mechanism. Accordingly, while WT Δ133p53α reduces apoptosis to promote DNA repair, mutant R273H also reduces apoptosis but fails to maintain genomic stability, increasing the risks of accumulation of mutations and tumor\'s deriving towards a more aggressive phenotype. Furthermore, using 2D and 3D spheroids culture, we show that WT Δ133p53α reduces cell proliferation, EMT, and invasion, while the mutant Δ133p53α R273H enhances all three processes, confirming its oncogenic potential and strongly suggesting a similar in vivo activity. Importantly, the effects on cell growth and invasion are independent of mutant full-length p53α, indicating that these activities are actively carried by mutant Δ133p53α R273H. Furthermore, both WT and mutant Δ133p53α reduce cellular senescence in a senescence inducer-dependent manner (temozolomide or radiation) because they regulate different senescence-associated target genes. Hence, WT Δ133p53α rescues temozolomide-induced but not radiation-induced senescence, while mutant Δ133p53α R273H rescues radiation-induced but not temozolomide-induced senescence. Lastly, we determined that IL4I1, IDO1, and AHR are significantly higher in GBMs compared to low-grade gliomas. Importantly, high expression of all three genes in LGG and IL4I1 in GBM is significantly associated with poorer patients\' survival, confirming the clinical relevance of this pathway in glioblastomas. These data show that, compared to WT Δ133p53α, R273H mutation reorientates its activities toward carcinogenesis and activates the oncogenic IL4I1/IDO1/AHR pathway, a potential prognostic marker and therapeutic target in GBM by combining drugs specifically modulating Δ133p53α expression and IDO1/Il4I1/AHR inhibitors.
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  • 文章类型: Journal Article
    目的:预后因素可以促进多形性胶质母细胞瘤(GBM)患者的个性化治疗。这项研究调查了在切除或活检后接受放化疗的GBM患者的不同格拉斯哥预后评分(GPS)和LabBM评分。
    方法:四个GPS版本,LabBM评分,对86例患者的无进展生存期(PFS)和总生存期(OS)进行了回顾性研究。GPS版本包括原始GPS(OGPS),修改后的GPS(MGPS),高灵敏度MGPS(HS-MGPS),和高灵敏度OGPS(HS-OGPS)。
    结果:关于多变量分析,较高的oGPS与较差的OS显著相关(p=0.006).在单变量分析中,发现mGPS较高和OS较差(p=0.098)以及LabBM评分较高和PFS较差(p=0.059)之间存在关联的趋势.
    结论:在接受GBM放化疗的患者中,oGPS是OS的独立预测因子,可以帮助这些患者的个性化治疗。LabBM评分可用于预测PFS。
    OBJECTIVE: Prognostic factors can facilitate treatment personalization in patients with glioblastoma multiforme (GBM). This study investigated different Glasgow prognostic scores (GPS) and the LabBM score in patients with GBM receiving chemoradiation following resection or biopsy.
    METHODS: Four GPS versions, LabBM score, and 10 other factors were retrospectively investigated for progression-free survival (PFS) and overall survival (OS) in 86 patients. GPS versions included original GPS (oGPS), modified GPS (mGPS), high-sensitivity mGPS (HS-mGPS), and high-sensitivity oGPS (HS-oGPS).
    RESULTS: On multivariate analysis, higher oGPS was significantly associated with worse OS (p=0.006). On univariate analyses, trends were found for associations between higher mGPS and worse OS (p=0.098) and between higher LabBM scores and worse PFS (p=0.059).
    CONCLUSIONS: The oGPS was an independent predictor of OS in patients receiving chemoradiation for GBM and can help personalizing the treatment for these patients. The LabBM score may be useful for predicting PFS.
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  • 文章类型: Case Reports
    目的:胶质瘤是来源于脑内多种细胞类型的高度异质性恶性肿瘤。虽然他们的确切病因往往是未知的,危险因素,例如化学暴露,辐射,和特定的不常见的遗传疾病已经确定。诊断通常需要影像学检查,如磁共振成像和计算机断层扫描,辅以活检确认,这可以通过基因检测进一步验证。
    方法:下一代测序技术揭示了根据肿瘤的分子特征诊断为多形性黄色星形细胞瘤的患者中细胞周期蛋白依赖性激酶抑制剂2A和B基因(CDKN2A和CDKN2B)的种系共缺失。根据这个结果,我们使用多重连接依赖性探针扩增技术对显示相同共缺失的母亲进行了集中的遗传分析.此外,由于父亲的神经内分泌胰腺癌,NGS技术的应用在BRCA1相互作用解旋酶1(BRIP1)基因中检测到致病性变异。在家族背景下进行的综合多基因检测,以各种各样的癌症类型为标志,揭示了一系列遗传倾向。
    结论:本案例研究强调了分子检测对肿瘤特征的重要性,并强调了基因检测在促进早期干预和筛查高危家庭成员中的关键作用。此外,癌症种系共缺失的鉴定为制定旨在恢复正常细胞调节和改善患者管理的靶向治疗策略奠定了基础.
    OBJECTIVE: Gliomas are highly heterogeneous malignancies originating from diverse cell types within the brain. Although their precise etiology is frequently unknown, risk factors, such as chemical exposure, radiation, and specific uncommon genetic disorders have been identified. Diagnosis typically entails imaging tests, such as magnetic resonance imaging and computed tomography, complemented by a biopsy for confirmation, which may be further validated through genetic testing.
    METHODS: Next-generation sequencing technology revealed germline co-deletion deletion of cyclin-dependent kinase inhibitor 2 A and B genes (CDKN2A and CDKN2B) in a patient diagnosed with pleomorphic xanthoastrocytoma based on the tumor\'s molecular characteristics. Following this result, we performed focused genetic analysis with use of multiplex ligation-dependent probe amplification technology for the mother that revealed the same co-deletion. Moreover, due to the father\'s neuroendocrine pancreatic cancer, application of the NGS technology detected a pathogenic variant in the BRCA1-interacting helicase 1 (BRIP1) gene. Comprehensive multi-gene testing conducted within the familial context, marked by a varied spectrum of cancer type, revealed a constellation of genetic predispositions.
    CONCLUSIONS: This case study underscores the critical importance of molecular testing for tumor characterization and highlights the pivotal role of genetic testing in facilitating early intervention and screening for at-risk family members. Furthermore, the identification of germline co-deletions in cancer lays the foundation for the development of targeted therapeutic strategies aimed at restoring normal cellular regulation and improving patient management.
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  • 文章类型: Journal Article
    胶质瘤是颅内最常见的原发性肿瘤,死亡率高,预后差。目的探讨NID2基因单核苷酸多态性(SNPs)对胶质瘤发病风险及预后的影响。通过AgenaMassARRAY质谱仪成功对529例神经胶质瘤患者和478例健康对照中的NID2的四个候选SNP进行了基因分型。使用Logistic回归评估不同遗传模型下NID2SNP与神经胶质瘤风险之间的关联。此外,通过Kaplan-Meier(KM)生存曲线和Cox比例风险回归分析,探讨NID2中风险相关SNPs与胶质瘤患者预后的关系.结果显示,rs11846847(OR1.24,p=0.017)和rs1874569(OR1.22,p=0.026)与胶质瘤风险增加显著相关,rs11846847对≤40岁参与者的神经胶质瘤也有增加风险的作用.rs11846847和rs1874569的交互作用模型更适合预测胶质瘤的发病风险。我们还发现rs1874569与神经胶质瘤患者的不良预后之间存在显着关联(HR1.32,p=0.039),尤其是CC基因型与高患者的总生存期(OS)和无进展生存期(PFS)相关。此外,研究表明,在中国汉族人群中,大体全切除或化疗可改善胶质瘤预后。本研究首次为NID2SNPs与神经胶质瘤风险和预后的相关性提供了证据,提示NID2变异可能是神经胶质瘤的潜在因素。
    Glioma is the most common primary intracranial tumor with high mortality and poor prognosis. The purpose of this study was to investigate how single-nucleotide polymorphisms (SNPs) of the NID2 gene affect glioma risk and prognosis. Four candidate SNPs of NID2 in 529 glioma patients and 478 healthy controls were successfully genotyped by Agena MassARRAY mass spectrometer. Logistic regression was utilized to assess the associations between NID2 SNPs and glioma risk under different genetic models. Furthermore, the relationship between risk-related SNPs in NID2 and the prognosis of glioma patients was explored through Kaplan-Meier (KM) survival curve and Cox proportional hazard regression analysis. The results showed that rs11846847 (OR 1.24, p = 0.017) and rs1874569 (OR 1.22, p = 0.026) were significantly associated with an increased risk of glioma, and rs11846847 also had a risk-increasing effect on glioma in participants ≤ 40 years old. The interaction model of rs11846847 and rs1874569 could be more suitable for forecasting glioma risk. We also discovered a significant association between rs1874569 and poor prognosis in glioma patients (HR 1.32, p = 0.039) and especially CC genotype was relevant to shorter overall survival (OS) and progression-free survival (PFS) in patients with high-grade glioma. Additionally, the study demonstrated that gross total resection or chemotherapy improve glioma prognosis in the Chinese Han population. This study is the first to provide evidence for the association of NID2 SNPs with glioma risk and prognosis, suggesting that NID2 variants might be potential factors for glioma.
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  • 文章类型: Journal Article
    这项研究描述了一种对胶质瘤病理切片进行分级的新方法。我们自己的集成高光谱成像系统用于表征来自神经胶质瘤微阵列载玻片的270条带癌组织样本。然后根据世界卫生组织制定的指南对这些样本进行分类,定义了弥漫性神经胶质瘤的亚型和等级。我们使用不同恶性等级的脑胶质瘤的显微高光谱图像探索了一种称为SMLMER-ResNet的高光谱特征提取模型。该模型结合通道注意机制和多尺度图像特征,自动学习胶质瘤的病理组织,获得分层特征表示,有效去除冗余信息的干扰。它还完成了多模态,多尺度空间谱特征提取提高胶质瘤亚型的自动分类。所提出的分类方法具有较高的平均分类精度(>97.3%)和Kappa系数(0.954),表明其在提高高光谱胶质瘤自动分类方面的有效性。该方法很容易适用于广泛的临床环境。为减轻临床病理学家的工作量提供宝贵的帮助。此外,这项研究有助于制定更个性化和更精细的治疗计划,以及随后的随访和治疗调整,通过为医生提供对神经胶质瘤潜在病理组织的见解。
    This study describes a novel method for grading pathological sections of gliomas. Our own integrated hyperspectral imaging system was employed to characterize 270 bands of cancerous tissue samples from microarray slides of gliomas. These samples were then classified according to the guidelines developed by the World Health Organization, which define the subtypes and grades of diffuse gliomas. We explored a hyperspectral feature extraction model called SMLMER-ResNet using microscopic hyperspectral images of brain gliomas of different malignancy grades. The model combines the channel attention mechanism and multi-scale image features to automatically learn the pathological organization of gliomas and obtain hierarchical feature representations, effectively removing the interference of redundant information. It also completes multi-modal, multi-scale spatial-spectral feature extraction to improve the automatic classification of glioma subtypes. The proposed classification method demonstrated high average classification accuracy (>97.3%) and a Kappa coefficient (0.954), indicating its effectiveness in improving the automatic classification of hyperspectral gliomas. The method is readily applicable in a wide range of clinical settings, offering valuable assistance in alleviating the workload of clinical pathologists. Furthermore, the study contributes to the development of more personalized and refined treatment plans, as well as subsequent follow-up and treatment adjustment, by providing physicians with insights into the underlying pathological organization of gliomas.
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  • 文章类型: Journal Article
    背景和目的:由于脑部病变存在复杂的诊断挑战,通过活检进行准确的组织采样对于有效的治疗计划至关重要。传统的基于框架的立体定向活检已得到导航活检技术的补充。利用成像和导航技术的进步。本研究旨在在临床环境中比较导航和基于框架的立体定向活检方法,评估它们的功效,安全,和诊断结果,以确定精确的脑部病变靶向的最佳方法。材料和方法:回顾性分析2017年1月至2023年8月在学术医学中心接受脑活检的患者。患者人口统计数据,临床特征,活检技术(导航与基于框架),结果包括准确性,并发症,并对住院时间进行分析。结果:该队列包括112例患者,组间年龄或性别差异无统计学意义。导致活检的症状主要是肌肉力量减弱(42.0%),认知问题(28.6%),失语症(24.1%)。肿瘤最常见于深半球(24.1%)。中位住院时间为5天,再住院率为27.7%。4.47%的患者出现并发症,活检方法之间没有显着差异。然而,导航活检导致样本较少(p<0.001),但与基于帧的活检具有相当的诊断准确性.结论:导航和基于框架的立体定向活检既有效又安全,具有可比的准确性和并发症发生率。技术的选择应考虑病变的具体情况,外科医生偏好,和技术可用性。研究结果强调了先进的神经外科技术在增强患者护理和预后方面的重要性。
    Background and Objectives: As brain lesions present complex diagnostic challenges, accurate tissue sampling via biopsy is critical for effective treatment planning. Traditional frame-based stereotactic biopsy has been complemented by navigated biopsy techniques, leveraging advancements in imaging and navigation technology. This study aims to compare the navigated and frame-based stereotactic biopsy methods in a clinical setting, evaluating their efficacy, safety, and diagnostic outcomes to determine the optimal approach for precise brain lesion targeting. Materials and Methods: retrospective analysis was conducted on patients who underwent brain biopsies between January 2017 and August 2023 at an academic medical center. Data on patient demographics, clinical characteristics, biopsy technique (navigated vs. frame-based), and outcomes including accuracy, complications, and hospital stay duration were analyzed. Results: The cohort comprised 112 patients, with no significant age or gender differences between groups. Symptoms leading to biopsy were predominantly diminished muscle strength (42.0%), cognitive issues (28.6%), and aphasia (24.1%). Tumors were most common in the deep hemisphere (24.1%). The median hospital stay was 5 days, with a rehospitalization rate of 27.7%. Complications occurred in 4.47% of patients, showing no significant difference between biopsy methods. However, navigated biopsies resulted in fewer samples (p < 0.001) but with comparable diagnostic accuracy as frame-based biopsies. Conclusions: Navigated and frame-based stereotactic biopsies are both effective and safe, with comparable accuracy and complication rates. The choice of technique should consider lesion specifics, surgeon preference, and technological availability. The findings highlight the importance of advanced neurosurgical techniques in enhancing patient care and outcomes.
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  • 文章类型: Journal Article
    胶质母细胞瘤是中枢神经系统中侵袭性最强的肿瘤,尽管进行了多模式治疗,但生存率仍低于15个月。肿瘤在切除后经常复发。肿瘤血管生成,新血管的形成,对肿瘤进展和侵袭有积极的影响,尽管在专业文献中关于其对生存的影响存在争议。这项研究旨在将原发性和继发性胶质母细胞瘤中血管生成标志物(CD34,CD105)的免疫表达与增殖指数Ki67和p53相关联。这项回顾性研究包括54例在县急诊临床医院病理科诊断为胶质母细胞瘤的患者。使用CD34和CD105抗体测定微血管密度,结果与p53,IDH1,ATRX和Ki67的免疫表达相关。新生血管的数量因病例而异,以不同的形状和口径为特征,内皮细胞表现出修饰的形态和中度至明显的多态性。有肾小球样的新血管,与内皮细胞中CD34或CD105的强烈阳性相关,被观察到,胶质母细胞瘤的特征。在所有情况下,CD34标志物的平均微血管密度值均较高,尽管与CD105相比没有统计学上的显着差异。突变IDH1和ATRX胶质母细胞瘤,野生型p53胶质母细胞瘤,Ki67指数超过20%的患者显示出更丰富的微血管密度,统计相关性未达到显著性。这项研究分别使用免疫组织化学标记CD34和CD105强调了原发性和继发性胶质母细胞瘤中微血管密度的各种百分比间隔,评估的微血管密度与p53或Ki67之间没有统计学上的显着相关性。
    Glioblastoma is the most aggressive tumor in the central nervous system, with a survival rate of less than 15 months despite multimodal therapy. Tumor recurrence frequently occurs after removal. Tumoral angiogenesis, the formation of neovessels, has a positive impact on tumor progression and invasion, although there are controversial results in the specialized literature regarding its impact on survival. This study aims to correlate the immunoexpression of angiogenesis markers (CD34, CD105) with the proliferation index Ki67 and p53 in primary and secondary glioblastomas. This retrospective study included 54 patients diagnosed with glioblastoma at the Pathology Department of County Emergency Clinical Hospital Târgu Mureș. Microvascular density was determined using CD34 and CD105 antibodies, and the results were correlated with the immunoexpression of p53, IDH1, ATRX and Ki67. The number of neoformed blood vessels varied among cases, characterized by different shapes and calibers, with endothelial cells showing modified morphology and moderate to marked pleomorphism. Neovessels with a glomeruloid aspect, associated with intense positivity for CD34 or CD105 in endothelial cells, were observed, characteristic of glioblastomas. Mean microvascular density values were higher for the CD34 marker in all cases, though there were no statistically significant differences compared to CD105. Mutant IDH1 and ATRX glioblastomas, wild-type p53 glioblastomas, and those with a Ki67 index above 20% showed a more abundant microvascular density, with statistical correlations not reaching significance. This study highlighted a variety of percentage intervals of microvascular density in primary and secondary glioblastomas using immunohistochemical markers CD34 and CD105, respectively, with no statistically significant correlation between evaluated microvascular density and p53 or Ki67.
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