Actualisation du diagnostic d'une série de 109 gliomes diffus selon la classification OMS 2016

Abstract : Introduction: the 2016 update of the WHO classification of diffuse gliomas integrates molecular data, including IDH mutations, and 1p/19q codeletion that is exclusive of ATRX mutations, leading to the suppression of the oligoastrocytoma group. The aims of this study were to reclassify the diagnosis of patients with diffuse glioma according to the 2016 WHO classification to analyze its feasibility and its prognostic impact. Materials and methods: 109 patients with grade II to IV glial tumor were included. The expression of IDH1R132H and ATRX was investigated by immunohistochemical analysis. The 1p/19q codeletion was assessed by FISH (fluorescent hybridization in situ) or by loss of heterozygosity of microsatellite markers via PCR techniques on all 1p and 19q arms. Results: 105/109 cases were reclassified. Grade II and III oligoastrocytomas (22) were reclassified to astrocytoma IDH mutant (IDHmut) (15), glioblastoma IDHmut (3), glioblastoma IDH wildtype (IDHwt) (1), astrocytoma IDHwt (2), and diffuse mideline tumor, H3K27M mutant (1). 10/105 patients were reclassified to glioblastoma IDHmut. The new WHO classification was prognostic for overall survival (p<0,001). Conclusion: the update of the WHO 2016 classification makes it possible in most cases to separate the diffuse gliomas of astrocytic phenotype from diffuse gliomas of oligodendroglial phenotype and has a high prognostic value. Its application already raises new questions, leading the cIMPACT-NOW consortium to publish new recommendations.
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Saeideh Khalessi. Actualisation du diagnostic d'une série de 109 gliomes diffus selon la classification OMS 2016. Médecine humaine et pathologie. 2018. ⟨dumas-02083858⟩

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