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Analysis of MGMT promoter methylation status on intraoperative fresh tissue section from frameless neuronavigation needle biopsy: a preliminary study of ten patients

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Abstract

Background

After a brain biopsy, the genetic analysis can fail because of insufficient material, extensive tumor necrosis, and formalin fixation under conditions that adversely affected the quality of the DNA or because the assay result was indeterminant. The freezing of fresh tumor tissue at surgery could greatly improve the success of DNA extraction and methyl guanine methyl transferase (MGMT) promoter methylation testing. The concentration of the DNA samples can also be improved from a withdrawal in an area with a high probability of neoplastic cells.

Methods

The present study reports the results of ten frameless image-guided intracranial needle biopsies from April 2008 until February 2009, among a total of 28 frameless neuronavigation brain biopsy performed from May 2007 to February 2009. The protocol sampling provided withdrawal specimens correlated with neuroimaging characteristics of the lesions. The molecular determination of MGMT promoter was assessed with the nested methylation-specific polymerase chain reaction on fresh or cryopreserved needle bioptic tissue.

Results

The genetic characterization was feasible in all the bioptic samples. The MGMT promoter was methylated in six patients, including a brain infection. The image-guided trajectory of the biopsy and the intraoperative frozen section increased the diagnostic yield.

Conclusions

To the best of the authors' knowledge, this is the first report with the MGMT promoter status analysis on needle bioptic fresh tissue. In the future, the availability of the molecular genetic characterization of a brain tumor before open surgery will provide important information for the optimal treatment.

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Abbreviations

A:

astrocytoma

AA:

anaplastic astrocytoma

AO:

anaplastic oligodendroglioma

bp:

base pair

CpG:

citosine guanine

CT:

computed tomography

DNA:

deoxyribonucleic acid

GBL:

glioblastoma

ICH:

immunohistochemistry

HPLC:

high-performance liquid chromatography

MGMT:

methyl guanine methyl transferase

MRI:

magnetic resonance imaging

MSP:

methylation specific PCR

PCR:

polymerase chain reaction

TMZ:

temozolamide

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Authors and Affiliations

  1. “Hub & Spoke” Neurosurgery Unit—Emergency Department, University Hospital of Parma, Viale Gramsci, 14, 43100, Parma, Italy

    Corrado Iaccarino, Davide Nasi, Reza Ghadirpour & Franco Servadei

  2. Laboratory of Molecular Biology, Arcispedale Santa Maria Nuova of Reggio Emilia, Viale Risorgimento, 80, 42100, Reggio Emilia, Italy

    Davide Nicoli

  3. Hystopathologic Unit, Arcispedale Santa Maria Nuova of Reggio Emilia, Viale Risorgimento, 80, 42100, Reggio Emilia, Italy

    Carmine Gallo

  4. Neurology Unit, Arcispedale Santa Maria Nuova of Reggio Emilia, Viale Risorgimento, 80, 42100, Reggio Emilia, Italy

    Anna Pisanello & Norina Marcello

  5. Neuroradiology Unit, Arcispedale Santa Maria Nuova of Reggio Emilia, Viale Risorgimento, 80, 42100, Reggio Emilia, Italy

    Gianni De Berti

  6. Emergency Neurosurgery Unit, Arcispedale Santa Maria Nuova of Reggio Emilia, Viale Risorgimento, 80, 42100, Reggio Emilia, Italy

    Corrado Iaccarino, Davide Nasi, Reza Ghadirpour & Franco Servadei

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  1. Corrado Iaccarino
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Correspondence to Corrado Iaccarino.

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Iaccarino, C., Nicoli, D., Gallo, C. et al. Analysis of MGMT promoter methylation status on intraoperative fresh tissue section from frameless neuronavigation needle biopsy: a preliminary study of ten patients. Acta Neurochir 152, 1189–1196 (2010). https://doi.org/10.1007/s00701-010-0639-0

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  • DOI: https://doi.org/10.1007/s00701-010-0639-0

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