J Pathol Transl Med.  2020 Mar;54(2):165-170. 10.4132/jptm.2020.02.04.

Adjunctive markers for classification and diagnosis of central nervous system tumors: results of a multi-center neuropathological survey in Korea

• Cha YJ
• Kim SH
• Kim NR
• The Neuropathology Study Group of the Korean Society of Pathologists

• KMID: 2501606
• DOI: http://doi.org/10.4132/jptm.2020.02.04

Abstract

Background
The revised 4th 2016 World Health Organization (WHO) classification of tumors of the central nervous system (CNS) classification has adopted integrated diagnosis encompassing the histology and molecular features of CNS tumors. We aimed to investigate the immunohistochemistry, molecular testing, and testing methods for diagnosis of CNS tumors in pathological labs of tertiary centers in Korea, and evaluate the adequacy of tests for proper diagnosis in daily practice.
Methods
A survey, composed of eight questions concerning molecular testing for diagnosis of CNS tumors, was sent to 10 neuropathologists working in tertiary centers in Korea.
Results
For diagnosis of astrocytic and oligodendroglial tumors, all 10 centers performed isocitrate dehydrogenase mutations testing and 1p/19q loss of heterozygosity. For glioneuronal tumors, immunohistochemistry (IHC) assays for synaptophysin (n = 9), CD34 (n = 7), BRAF(VE1) (n = 5) were used. For embryonal tumors, particularly in medulloblastoma, four respondents used IHC panel (growth factor receptor bound protein 2-associated protein 1, filamin A, and yes-associated protein 1) for molecular subclassification. Regarding meningioma, all respondents performed Ki-67 IHC and five performed telomerase reverse transcriptase promoter mutation.
Conclusions
Most tertiary centers made proper diagnosis in line with 2016 WHO classification. As classification of CNS tumors has evolved to be more complex and more ancillary tests are required, these should be performed considering the effect of necessity and justification.

Keyword

World Health Organization; Central nervous system; Neoplasms; Molecular testing; Korea

Figure

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  Fig. 1. Immunohistochemistry markers used in glioma (A) and ependymoma (B). Alphabet A–J represents respondents. IDH1, isocitrate dehydrogenase 1; ATRX, α-thalassemia/mental retardation syndrome X-linked; GFAP, glial fibrillary acidic protein; EGFR, epidermal growth factor receptor; OLIG2, oligodendrocyte transcription factor 2; EMA, epithelial membrane antigen.

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  Fig. 2. Current methods for isocitrate dehydrogenase (IDH) mutation test (A) and 1p/19q status (B) among respondents. PNA, peptide nucleic acid; NGS, next-generation sequencing; FISH, fluorescence in situ hybridization; PCR, polymerase chain reaction; LOH, loss of heterozygosity.

• 

  Fig. 3. Immunohistochemistry markers used in ganglioglioma (A) and dysembryoplastic neuroepithelial tumor (B). Alphabet A–J represents respondents. GFAP, glial fibrillary acidic protein; IDH1, isocitrate dehydrogenase 1; OLIG2, oligodendrocyte transcription factor 2; ATRX, α-thalassemia/mental retardation syndrome X-linked.

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