Ann Lab Med.  2016 Nov;36(6):583-589. 10.3343/alm.2016.36.6.583.

Relationship Between Cytogenetic Complexity and Peritumoral Edema in High-Grade Astrocytoma

• Jeong KH
• Song YJ
• Han JY
• Kim KU

• KMID: 2373597
• DOI: http://doi.org/10.3343/alm.2016.36.6.583

Abstract

BACKGROUND
The purpose of the study is to reveal the association of cytogenetic compltyexi and peritumoral edema volume (PTEV) and its prognostic significance in high-grade astrocytoma patients by culturing patient tumor cells.
METHODS
Twenty-seven high-grade astrocytoma patients were divided into three groups according to karyotype complexity: normal, non-complex karyotype (NCK), and complex karyotype (CK). Endothelial growth factor receptor (EGFR) amplification was detected by FISH, and its association with chromosome 7 abnormalities was analyzed. Mean PTEV of each group was compared by ANOVA to evaluate the relationship between PTEV and cytogenetic complexity.
RESULTS
The PTEV of patients in normal (n=6), NCK (n=8), and CK (n=13) groups were 24.52±17.73, 34.26±35.04, and 86.31±48.7 cm3, respectively (P=0.005). Ten out of 11 patients with EGFR amplification showed abnormalities in chromosome 7. The mean PTEV of EGFR-amplified and non-amplified groups were 80.4±53.7 and 41.3±37.9 cm3, respectively (P=0.035). The average survival of patients with PTEV less than 90 cm3 was 30.52±26.11 months, while in patients with PTEVs over or equal to 90 cm3, it was 10.83±5.53 months (P=0.007).
CONCLUSIONS
The results show an association of complex karyotype with the PTEV of high-grade astrocytoma. EGFR amplification plays a significant role in the formation of peritumoral edema, causing PTEV to increase, which is related with survival. This implies that cytogenetic karyotype can be applied as a prognostic factor.

Keyword

High-grade astrocytoma; Chromosome; EGFR amplification; Peritumoral edema

MeSH Terms

Adult
Aged
Astrocytoma/diagnostic imaging/mortality/*pathology
Brain Neoplasms/diagnostic imaging/mortality/*pathology
Chromosome Aberrations
Chromosomes, Human, Pair 7
Edema/diagnostic imaging/pathology
Female
Humans
In Situ Hybridization, Fluorescence
Kaplan-Meier Estimate
Karyotype
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Grading
Prognosis
Receptors, Vascular Endothelial Growth Factor/metabolism
Tumor Cells, Cultured
Young Adult
Receptors, Vascular Endothelial Growth Factor

Figure

• 

  Fig. 1 Kaplan-Meier Survival curve of patients with peritumoral edemas less than 90 cm3 and patients with peritumoral edema of 90 cm3 or greater, as analyzed by the log-rank test.

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  Fig. 2 T2 FLAIR image (A) and T1 gadolinium-enhanced magnetic resonance imaging (MRI) image (B) of a 55-yr-old anaplastic astrocytoma patient with a normal female chromosome (C) and without EGFR amplification. There is minimal high signal around the tumor mass. The survival of the patient was 110 months.

• 

  Fig. 3 T1 gadolinium-enhanced magnetic resonance imaging (MRI) image (A) and T2 FLAIR image (B) of a 66-yr-old glioblastoma multiforme patient with complex karyotype (C) and positive EGFR amplification. A large amount of peritumoral edema with a midline shift was confirmed by T2 FLAIR image. 50,XY, dic(1;4)(p1 3;q35),+5,+7,+7,add(6p),del(7)(p15),add(9)(p24),add(17)(q25) add(19)(q13.4), add(21)(p13),+mar[20]. The survival of the patient was 9 months.

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