Journal of Neuro-Oncology

, Volume 117, Issue 1, pp 183–189

High expression of the stem cell marker nestin is an adverse prognostic factor in WHO grade II–III astrocytomas and oligoastrocytomas

  • Kimmo J. Hatanpaa
  • Tianshen Hu
  • Vamsidhara Vemireddy
  • Chan Foong
  • Jack M. Raisanen
  • Dwight Oliver
  • Matthew C. Hiemenz
  • Dennis K. Burns
  • Charles L. WhiteIII
  • L. Anthony Whitworth
  • Bruce Mickey
  • Martha Stegner
  • Amyn A. Habib
  • Karen Fink
  • Elizabeth A. Maher
  • Robert M. Bachoo
Clinical Study

DOI: 10.1007/s11060-014-1376-7

Cite this article as:
Hatanpaa, K.J., Hu, T., Vemireddy, V. et al. J Neurooncol (2014) 117: 183. doi:10.1007/s11060-014-1376-7

Abstract

Infiltrating astrocytomas and oligoastrocytomas of low to anaplastic grade (WHO grades II and III), in spite of being associated with a wide range of clinical outcomes, can be difficult to subclassify and grade by the current histopathologic criteria. Unlike oligodendrogliomas and anaplastic oligodendrogliomas that can be identified by the 1p/19q codeletion and the more malignant glioblastomas (WHO grade IV astrocytomas) that can be diagnosed solely based on objective features on routine hematoxylin and eosin sections, no such objective criteria exist for the subclassification of grade II–III astrocytomas and oligoastrocytomas (A+OA II–III). In this study, we evaluated the prognostic and predictive value of the stem cell marker nestin in adult A+OA II–III (n = 50) using immunohistochemistry and computer-assisted analysis on tissue microarrays. In addition, the correlation between nestin mRNA level and total survival was analyzed in the NCI Rembrandt database. The results showed that high nestin expression is a strong adverse prognostic factor for total survival (p = 0.0004). The strength of the correlation was comparable to but independent of the isocitrate dehydrogenase 1/2 (IDH 1/2) mutation status. Histopathological grading and subclassification did not correlate significantly with outcome, although the interpretation of this finding is limited by the fact that grade III tumors were treated more aggressively than grade II tumors. These results suggest that nestin level and IDH 1/2 mutation status are strong prognostic features in A+OA II–III and possibly more helpful for treatment planning than routine histopathological variables such as oligodendroglial component (astrocytoma vs. oligoastrocytoma) and WHO grade (grade II vs. III).

Keywords

Mixed glioma Outcome Prognosis Progression-free survival Low-grade gliomas Anaplastic gliomas 

Supplementary material

11060_2014_1376_MOESM1_ESM.doc (83 kb)
Supplementary material 1 (DOC 83 kb)

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Kimmo J. Hatanpaa
    • 1
  • Tianshen Hu
    • 1
  • Vamsidhara Vemireddy
    • 2
  • Chan Foong
    • 1
  • Jack M. Raisanen
    • 1
  • Dwight Oliver
    • 1
  • Matthew C. Hiemenz
    • 1
  • Dennis K. Burns
    • 1
  • Charles L. WhiteIII
    • 1
  • L. Anthony Whitworth
    • 3
  • Bruce Mickey
    • 3
  • Martha Stegner
    • 2
  • Amyn A. Habib
    • 2
    • 5
  • Karen Fink
    • 2
  • Elizabeth A. Maher
    • 2
    • 4
  • Robert M. Bachoo
    • 2
    • 4
  1. 1.Department of PathologyUniversity of Texas Southwestern Medical CenterDallasUSA
  2. 2.Department of Neurology and NeurotherapeuticsUniversity of Texas Southwestern Medical CenterDallasUSA
  3. 3.Department of Neurological SurgeryUniversity of Texas Southwestern Medical CenterDallasUSA
  4. 4.Department of Internal MedicineUniversity of Texas Southwestern Medical CenterDallasUSA
  5. 5.VA North Texas Health Care SystemDallasUSA

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