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Title: Immunohisto Chemical Expression of IDH1, ATRX and P53 in Low Grade Diffuse Gliomas at Armed Forces Institute of Pathology, Rawalpindi
Authors: Ayesha Arif, Farhan Akhtar, Ahmed Ahson, Hafeez Uddin, Rabia Ahmed, Aminah Ahmed
Journal: Pakistan Armed Forces Medical Journal (PAFMJ)
Publisher: Army Medical College, Rawalpindi.
Country: Pakistan
Year: 2022
Volume: 72
Issue: 3
Language: English
DOI: 10.51253/pafmj.v72i3.6851
Keywords: Diffuse gliomaIDH1Low gradep53ATRX
Objective: To determine the immune histochemical expression of IDH1, ATRX and p53 in low-grade diffuse gliomas.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Jan to Jun 2020.
Methodology: Forty-two cases of low-grade diffuse glioma were included in the study. The cases were stratified into diffuse astrocytoma and oligodendroglioma based on results of immunohistochemistry expression for IDH1, ATRX and p53.
Results: The frontal lobe was the most commonly affected site 14 (33.3%). Based on the results of immunohistochemistry expression, 26 cases (61.9%) were diagnosed as an oligodendroglioma, while 16 cases (38.1%) were diagnosed as diffuse astrocytoma. All cases were assigned who grade II out of IV. In oligodendrogliomas, all cases (100%) were IDH1 mutants with the retained expression of ATRX and wild type expression of p53. Among the 16 cases of diffuse astrocytoma, IDH1 was mutant in 12 cases (75%), ATRX expression was lost in all cases, and p53 was mutant in 6 cases (37.5%).
Conclusion: The study showed that low-grade diffuse gliomas could be stratified and sub-classified in accordance with the World Health Organization (WHO) classification of CNS tumours (2016) successfully by application of immunohistochemistry for IDH1, ATRX and p53.
To determine the immune histochemical expression of IDH1, ATRX and p53 in low-grade diffuse gliomas.
Cross-sectional study involving 42 cases of low-grade diffuse glioma. Immunohistochemistry was performed for IDH1, ATRX, and p53. Cases were stratified into diffuse astrocytoma and oligodendroglioma based on these results. Statistical analysis was performed using SPSS version 22.0.
graph TD;
A["Obtain Review Board Approval"] --> B["Collect 42 Low-Grade Diffuse Glioma Cases"];
B --> C["Prepare FFPE Tissue Sections"];
C --> D["Perform Immunohistochemistry for IDH1, ATRX, p53"];
D --> E["Classify Tumors based on IHC Results"];
E --> F["Analyze Data using SPSS"];
F --> G["Stratify and Sub-classify Gliomas"];
G --> H["Draw Conclusions"];
The study supports the integration of immunohistochemical analysis for IDH1, ATRX, and p53 in the classification of low-grade diffuse gliomas, aligning with the WHO CNS tumour classification. These markers aid in stratifying patients into prognostic subcategories for optimized treatment. The findings are comparable to other studies conducted globally.
- The frontal lobe was the most commonly affected site (33.3%).
- 61.9% of cases were diagnosed as oligodendroglioma, and 38.1% as diffuse astrocytoma.
- All oligodendrogliomas (100%) were IDH1 mutants with retained ATRX and wild-type p53 expression.
- In diffuse astrocytomas, 75% were IDH1 mutant, ATRX expression was lost in all cases, and 37.5% were p53 mutant.
Immunohistochemistry for IDH1, ATRX, and p53 can successfully stratify and sub-classify low-grade diffuse gliomas according to the WHO classification. However, validation with additional molecular testing is recommended due to the increasing emphasis on molecular markers.
- 42 cases of low-grade diffuse glioma were included in the study. (Confirmed in Methodology and Results)
- 61.9% of cases were diagnosed as oligodendroglioma. (Confirmed in Results)
- All oligodendrogliomas (100%) were IDH1 mutants. (Confirmed in Results)
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