Abstract
The publication of the 2016 World Health Organization Classification of Tumors of the Central Nervous System (2016 WHO CNS) represented a major change in the classification of brain tumors. However, many pathologists in Japan cannot diagnose astrocytic or oligodendroglial tumors according to the 2016 WHO CNS due to financial or technical problems. Therefore, the Japan Society of Brain Tumor Pathology established a committee for molecular diagnosis to facilitate the integrated diagnosis of astrocytic and oligodendroglial tumors in Japan. We created three levels of diagnoses: Level 1 was defined as simple histopathological diagnosis using hematoxylin and eosin staining and routine cell lineage-based immunostaining. Level 2 was defined as immunohistochemical diagnosis using immunohistochemical examinations using R132H mutation-specific IDH1, ATRX, and/or p53 antibodies. Level 3 was defined as molecular diagnosis, such as diagnosis based on 1p/19q status or the mutation status of the IDH1 and IDH2 genes. In principle, astrocytic and oligodendroglial tumors should be diagnosed based on the 2016 WHO CNS and/or cIMPACT-NOW criteria; however, the findings obtained through our diagnostic flowchart can be added to the histological diagnosis in parentheses. This classification system would be helpful for pathologists with limited resources.
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References
Louis DN, Ohgaki H, Wiestler OD et al (2016) World Health Organization histological classification of tumours of the central nervous system. International Agency for Research on Cancer, Lyon
Louis DN, Wesseling P, Paulus W et al (2018) cIMPACT-NOW update 1: not otherwise specified (NOS) and not elsewhere classified (NEC). Acta Neuropathol 135:481–484
Louis DN, Giannini C, Capper D et al (2018) cIMPACT-NOW update 2: diagnostic clarifications for diffuse midline glioma, H3 K27M-mutant and diffuse astrocytoma/anaplastic astrocytoma, IDH-mutant. Acta Neuropathol 135:639–642
Brat DJ, Aldape K, Colman H et al (2018) cIMPACT-NOW update 3: recommended diagnostic criteria for “Diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma, WHO grade IV”. Acta Neuropathol 136:805–810
Capper D, Weissert S, Balss J et al (2010) Characterization of R132H mutation-specific IDH1 antibody binding in brain tumors. Brain Pathol 20:245–254
Mukasa A, Takayanagi S, Saito K et al (2012) Significance of IDH mutations varies with tumor histology, grade, and genetics in Japanese glioma patients. Cancer Sci 103:587–592
Arita H, Narita Y, Fukushima S et al (2013) Upregulating mutations in the TERT promoter commonly occur in adult malignant gliomas and are strongly associated with total 1p19q loss. Acta Neuropathol 126:267–276
Yan H, Parsons DW, Jin G et al (2009) IDH1 and IDH2 mutations in gliomas. N Engl J Med 360:765–773
Liu XY, Gerges N, Korshunov A et al (2012) Frequent ATRX mutations and loss of expression in adult diffuse astrocytic tumors carrying IDH1/IDH2 and TP53 mutations. Acta Neuropathol 124:615–625
Brat DJ, Verhaak RG, Cancer Genome Atlas Research Network et al (2015) Comprehensive, integrative genomic analysis of diffuse lower-grade gliomas. N Engl J Med 372: 2481–2498
Suzuki H, Aoki K, Chiba K et al (2015) Mutational landscape and clonal architecture in grade II and III gliomas. Nat Genet 47:458–468
Takami H, Yoshida A, Fukushima S (2015) Revisiting TP53 Mutations and Immunohistochemistry—a comparative study in 157 diffuse gliomas. Brain Pathol 25:256–265
Reuss DE, Sahm F, Schrimpf D et al (2015) ATRX and IDH1-R132H immunohistochemistry with subsequent copy number analysis and IDH sequencing as a basis for an “integrated” diagnostic approach for adult astrocytoma, oligodendroglioma and glioblastoma. Acta Neuropathol 129:133–146
Tanboon J, Williams EA, Louis DN (2016) The diagnostic use of immunohistochemical surrogates for signature molecular genetic alterations in gliomas. J Neuropathol Exp Neurol 75:4–18
Ichimura K, Vogazianou AP, Liu L et al (2008) 1p36 is a preferential target of chromosome 1 deletions in astrocytic tumours and homozygously deleted in a subset of glioblastomas. Oncogene 27: 2097–2108
Horbinski C, Nikiforova MN, Hobbs J et al (2012) The importance of 10q status in an outcomes-based comparison between 1p/19q fluorescence in situ hybridization and polymerase chain reaction-based microsatellite loss of heterozygosity analysis of oligodendrogliomas. J Neuropathol Exp Neurol 71(1):73–82
Acknoledgements
Koichi Ichimura: Division of Brain Tumor Translational Research, National Cancer Center Research, Institute, Tokyo, Japan; Hidehiro Oka: Department of Neurosurgery, Kitasato University Medical Center, Saitama, Japan; Junji Shibahara: Department of Pathology, Kyorin University Hospital, Tokyo, Japan; Naoya Hashimoto: Department of Neurosurgery, Kyoto Prefectural University Graduate School of Medical Science, Kyoto, Japan; Yonehiro Kenemura: Division of Biomedical Research and Innovation, Institute for Clinical Research, Osaka, National Hospital, National Hospital Organization, Osaka, Japan: Atsushi Natsume: Department of Neurosurgery, Nagoya University School of Medicine, Aichi, Japan; Sumito Nobusawa, Department of Human Pathology, Gunma University Graduate School of Medicine, Gunma, Japan; Keisuke Ueki: Department of Neurosurgery, Dokkyo Medical University, Tochigi, Japan; Takashi Komori: Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan, Neurological Hospital, Tokyo, Japan; Makoto Shibuya: Central Clinical Laboratory, Hachioji Medical Center, Tokyo Medical University, Hachioji, Tokyo, Japan; Akira Matsumura: Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
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The members of the The committee for molecular diagnosis of the Japan Society of Brain Tumor Pathology mentioned in Acknowledgements section.
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Sonoda, Y., Yokoo, H., Tanaka, S. et al. Practical procedures for the integrated diagnosis of astrocytic and oligodendroglial tumors. Brain Tumor Pathol 36, 56–62 (2019). https://doi.org/10.1007/s10014-019-00337-y
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DOI: https://doi.org/10.1007/s10014-019-00337-y