長期生存膠芽腫症例の病理学的検討
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概要
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Glioblastoma is the most common and malignant primary brain tumor. Factors such as age, Karnofsky performance score (KPS), and extent of resection have been shown to be prognostic for survival in newly diagnosed malignant glioma patients. O6-methylguanine DNA-methyltransferase (MGMT) promoter methylation status is also a prognostic factor in newly diagnosed glioblastoma patients. IDH1 mutation detected by direct sequencing or by immunochemistry of its more frequent form has been reported to be a strong and independent prognostic factor in gliomas whatever the grade. 1p/19q deletions are prognostic factors in oligodendroglial tumors and predict better survival after both chemotherapy and radiotherapy. Expression of immunohistochemical staining for α-Internexin was reported to correlate with 1p/19q deletions.We have two glioblastoma long term survivors and these cases showed similar clinical and radiological presentation with other glioblastoma cases who relapsed and survived less than a year. We investigated immunohistochemical staining for IDH1-R132H, MGMT and α-Internexin in these two cases and all stainings were negative. We should have more attention for other prognostic factors in glioblastoma long term survivors.
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