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Evidence-Based Diagnostic Algorithm for Glioma: Analysis of the Results of Pathology Panel Review and Molecular Parameters of EORTC 26951 and 26882 Trials.
- Source :
-
Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2015 Jun 10; Vol. 33 (17), pp. 1943-50. Date of Electronic Publication: 2015 Apr 27. - Publication Year :
- 2015
-
Abstract
- Purpose: With the rapid discovery of prognostic and predictive molecular parameters for glioma, the status of histopathology in the diagnostic process should be scrutinized. Our project aimed to construct a diagnostic algorithm for gliomas based on molecular and histologic parameters with independent prognostic values.<br />Methods: The pathology slides of 636 patients with gliomas who had been included in EORTC 26951 and 26882 trials were reviewed using virtual microscopy by a panel of six neuropathologists who independently scored 18 histologic features and provided an overall diagnosis. The molecular data for IDH1, 1p/19q loss, EGFR amplification, loss of chromosome 10 and chromosome arm 10q, gain of chromosome 7, and hypermethylation of the promoter of MGMT were available for some of the cases. The slides were divided in discovery (n = 426) and validation sets (n = 210). The diagnostic algorithm resulting from analysis of the discovery set was validated in the latter.<br />Results: In 66% of cases, consensus of overall diagnosis was present. A diagnostic algorithm consisting of two molecular markers and one consensus histologic feature was created by conditional inference tree analysis. The order of prognostic significance was: 1p/19q loss, EGFR amplification, and astrocytic morphology, which resulted in the identification of four diagnostic nodes. Validation of the nodes in the validation set confirmed the prognostic value (P < .001).<br />Conclusion: We succeeded in the creation of a timely diagnostic algorithm for anaplastic glioma based on multivariable analysis of consensus histopathology and molecular parameters.<br /> (© 2015 by American Society of Clinical Oncology.)
- Subjects :
- Adult
Aged
Algorithms
Biomarkers, Tumor analysis
Brain Neoplasms chemistry
Chromosome Deletion
Chromosomes, Human, Pair 10 genetics
Chromosomes, Human, Pair 7 genetics
DNA Methylation
DNA Modification Methylases genetics
DNA Repair Enzymes genetics
ErbB Receptors genetics
Evidence-Based Medicine
Female
Gene Amplification
Glioma chemistry
Humans
Isocitrate Dehydrogenase genetics
Male
Microscopy
Middle Aged
Mutation
Proportional Hazards Models
Tumor Suppressor Proteins genetics
User-Computer Interface
Biomarkers, Tumor genetics
Brain Neoplasms genetics
Brain Neoplasms pathology
Glioma genetics
Glioma pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1527-7755
- Volume :
- 33
- Issue :
- 17
- Database :
- MEDLINE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 25918297
- Full Text :
- https://doi.org/10.1200/JCO.2014.59.0166