Essential Information About Glioma You Must Know

Molecular Markers:

1p/19q co-deletion
EGFR amplificatio
p16 deletion

Overview

(A) Definition: Brain tumors that are derived from Glial cells.

(B) Incidence (India): A recent report on the cancer registry survey conducted by Indian Council for Medical Research on Glioma incidence in India revealed its effect in the following major cities: 5.8% – Mumbai, 6.7% – Bangalore, 3.5% – Chennai, 5.6% -Dibrugarh and 28.2% in Thiruvananthpuram.

(C) Nomenclature:

Named according to the type of the cell, they “mimic”:

• Ependymoma
• Astrocytoma (e.g. Glioblastoma Multiforme)
• Oligodendroglioma (”pure Oligodendroglial tumors”)
• Mixed Glioma (e.g. Oligoastrocytoma)

(D) Classification:

Astrocytoma
Histopathological Grading (WHO 2007)

(A) Incidence:

3 per 100,000 persons/year
27%-43% (most common) of all gliomas

(B) WHO grading:

• grade II (low grade)
  – Diffusely infiltrating Astrocytoma (DA)
  – approx. 8%

• grade III
  – Anaplastic Astrocytoma (AA)
  – approx. 20%

• grade IV
  – GlioBlastoma Multiforme (GBM)
  – approx. 70%

Oligodendroglioma
Histopathological Grading (WHO 2007)

(A) Incidence:

0.3-0.4 per 100,000 persons/year
4%-15% of all gliomas

(B) WHO grading:

• grade II (low grade)
  – “well-differentiated Oligodendroglioma”
  – approx. 77%

• grade III (high grade)
  -“more”malignant anaplastic oligodendroglioma”
  – approx. 23%

1p/19q Co-Deletion as Molecular Marker
Marker for Differential Diagnosis

“The histological distinction between Oligodendrogliomas and Astrocytomas is often difficult and
immunohistochemical analysis does not provide useful information for a differential diagnosis.”

* Molinari et al. Int J Mol Med. 2010

• 1p/19q Co-Deletion is preferentially associated with Oligodendroglial vs Astrocytic Neoplasms, which helps in avoiding tumor misclassification

• AOs and AOAs with 19p/19q co-deletion show similar clinical Behavior

* Horbinski Semin Diagn Pathol. 2010

1p/19q Co-Deletion as Molecular Marker
Glioma

“At the present time, molecular testing is recommended for all Anaplastic Oligodendroglial Tumors.”

*odriguez and Giannini Semin Diagn Pathol. 2010

Survey of treatment recommendations for Anaplastic Oligodendroglioma.

*Abrey et al. Neuro-Oncology 2007

Reported molecular genetic testing by Tumor Type

• Anaplastic Oligodendroglioma 95%
• Mixed Glioma (Oligoastrocytoma) 92%
• Anaplastic Astrocytoma 3%
• Low-grade Oligodendroglioma 14%
• Glioblastoma 7%

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