Inverse correlation between genetic aberrations and malignancy grade in ependymal tumors: a paradox?
H J Gilhuis1, J van der Laak, P Wesseling
1Department of Neurology, University Medical Center St Radboud, Nijmegen, The Netherlands. h.gilhuis@czzoneu.umcn.nl
Objective:
The goal of our study was to investigate the inverse correlation between number of genetic aberrations and malignancy grade in ependymal tumors at the ploidy level.
Methods:
we examined seven myxopapillary ependymomas (mpEs) (WHO grade I), 28 spinal and cerebral ependymomas (Es) (WHO grade II), and 18 cerebral anaplastic ependymomas (aEs) (WHO grade III) using image DNA cytometry. The ploidy status was correlated with clinicopathological characteristics and with the results obtained by comparative genomic hybridization (CGH) analysis that we performed in about half of these tumors.
Results:
mpEs were exclusively located in the spinal cord and aEs in the cerebrum only, whereas Es were located in both the spinal cord and brain. We found aneuploidy or tetraploidy to be common in the group of mpEs (6 out of 7) and much less frequent in Es (6 out of 28) and aEs (4 out of 18). Three-year postoperative survival was 100% for mpEs, 100% for spinal Es, 92% for cerebral Es, and 33% for aEs. Our CGH results in a selection of these tumors revealed the highest number of genetic aberrations in the mpEs (average 16; n = 2), a lower number in Es (average 12; n = 11) and the lowest number in aEs (average 5; n = 6). Interestingly, in the group of Es and aEs, a high number of genetic aberrations as detected by CGH was not correlated with aneuploidy or tetraploidy. Three patients, all with mpEs had local seeding.
Conclusion:
These results underline that mpEs are distinctly different from Es and aEs at the genetic level and that extensive genomic alterations and aneuploidy in ependymal tumors are not in itself an indicator of malignant behavior.
Insights
Myxopapillary ependymomas (mpEs) show distinct genetic differences from other ependymomas (Es) and anaplastic ependymomas (aEs). Extensive genomic alterations do not always indicate malignant behavior in these brain tumors.
Area of Science:
- Neuro-oncology
- Cancer Genomics
- Pathology
Background:
- Ependymal tumors encompass a spectrum of glial neoplasms with varying grades of malignancy.
- Understanding the genetic underpinnings of ependymal tumor subtypes is crucial for accurate diagnosis and prognosis.
Purpose of the Study:
- To investigate the correlation between genetic aberrations and malignancy grade in ependymal tumors at the ploidy level.
- To differentiate genetic profiles of myxopapillary ependymomas (mpEs), ependymomas (Es), and anaplastic ependymomas (aEs).
Main Methods:
- Image DNA cytometry and comparative genomic hybridization (CGH) were employed.
- Seven mpEs (WHO grade I), 28 Es (WHO grade II), and 18 aEs (WHO grade III) were analyzed.
- Ploidy status and CGH results were correlated with clinicopathological data.
Main Results:
- mpEs, predominantly spinal, showed high rates of aneuploidy/tetraploidy (6/7).
- Es (spinal/cerebral) and aEs (cerebral) had lower rates of aneuploidy/tetraploidy (6/28 and 4/18, respectively).
- CGH revealed the highest number of genetic aberrations in mpEs (avg. 16), fewer in Es (avg. 12), and the least in aEs (avg. 5).
- Aneuploidy did not consistently correlate with high genetic aberrations in Es and aEs.
Conclusions:
- Myxopapillary ependymomas exhibit a distinct genetic profile compared to other ependymoma subtypes.
- Extensive genomic alterations and aneuploidy in ependymal tumors do not solely predict malignant behavior.
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