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Published on: August 25, 2021
Nestin expression in central nervous system germ cell tumors
1Department of Neurosurgery, Yamagata University School of Medicine, 2-2-2 Iidanishi, Yamagata, Yamagata 990-9585, Japan. kasakura@med.id.yamagata-u.ac.jp
Abstract:
Central nervous system (CNS) germ cell tumors constitute a unique class of rare tumors that mainly affect children and adolescents. These tumors are believed to originate from displaced primordial germ cells. Recently, results of treatment of germ cell tumors have improved with use of radiotherapy and combination chemotherapy. However, some tumors have proven refractory to intensive treatment with surgery, radiation, and combination chemotherapy. Nestin is an intermediate filament protein expressed in undifferentiated cells during CNS development and in CNS tumors and is used as a marker of immature elements of tumors, including brain tumor stem cells. In this study, we examined for the first time nestin expression in 19 CNS germ cell tumors (nine pure germinomas, five germinomas with syncytiotrophoblastic giant cells, one yolk sac tumor, one choriocarcinoma, one embryonal carcinoma, and two mature teratomas). Nestin was expressed in 14 cases but was not expressed in three pure germinomas and two mature teratomas. Clinically, nestin-negative tumors did not exhibit dissemination, while all tumors that exhibited dissemination also strongly expressed nestin protein. These findings suggest that the detection of nestin expression could be useful in the management of CNS germ cell tumors, as an auxiliary predictor of dissemination and/or progression.
Insights
Nestin protein expression in central nervous system (CNS) germ cell tumors may predict tumor spread. Detecting nestin in these rare pediatric brain tumors could aid in managing dissemination and progression.
Area of Science:
- Neuro-oncology
- Developmental Biology
- Cancer Research
Background:
- Central nervous system (CNS) germ cell tumors are rare, primarily affecting children and adolescents, originating from displaced primordial germ cells.
- While treatments like chemotherapy and radiotherapy have improved outcomes, some CNS germ cell tumors remain refractory.
- Nestin, an intermediate filament protein, marks undifferentiated cells and is found in CNS tumors, including brain tumor stem cells.
Purpose of the Study:
- To investigate nestin expression in various types of CNS germ cell tumors for the first time.
- To determine the correlation between nestin expression and clinical behavior, specifically tumor dissemination and progression.
Main Methods:
- Examined nestin protein expression in 19 CNS germ cell tumors, including germinomas, yolk sac tumors, choriocarcinomas, embryonal carcinomas, and teratomas.
- Correlated nestin expression levels with clinical data on tumor dissemination.
Main Results:
- Nestin was expressed in 14 out of 19 CNS germ cell tumors.
- Nestin was not detected in pure germinomas or mature teratomas.
- Nestin-negative tumors showed no dissemination, while all disseminating tumors strongly expressed nestin.
Conclusions:
- Nestin expression is a potential biomarker in CNS germ cell tumors.
- Detecting nestin could serve as an auxiliary predictor for tumor dissemination and progression in CNS germ cell tumors.
- This finding may assist in the clinical management of these rare pediatric neoplasms.
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