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  • Immunohistochemical aspects in different portions of Glioblastoma (solid and infiltrative)

    Final Number:

    Luiz Daniel Cetl MD; Manoel de Paiva Neto; Oreste P. Lanzoni; Miguel Montes Canteras MD, PhD; Joao Norberto Stavale MD, PhD; Suzana M. Fleury Malheiros MD, PhD; Sergio Cavalheiro

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2016 Annual Meeting - Late Breaking Science

    Introduction: The glioblastoma is a malignant tumor, responsible for about 50% of primary tumor of central nervous system (CNS). However, not much is studied in infiltrative portion of glioblastomas about immunohistochemical characteristics when compared to the solid portion. Specially if this could mean that the infiltrative portion is less aggressive than solid portion. As this two portions have different characterisics at macroscopy and in image studies as well, we could imagine that they have different behavior in immunohistochemical studies. And, as largely accepted nowadays, the gross total ressection (ressection of solid portion) has an important role in a longer survival, so we can assume that the solid portion is immunohistochemically more aggressive than infiltrative portion.

    Methods: We made a retrospective study with data collected from 10 consecutive adult patients (18 years old or more), from both genders, with confirmed diagnostic of glioblastoma. With surgeries performed at Hospital São Paulo, by Neurosurgery discipline of Escola Paulista de Medicina/UNIFESP. All of them with pre operative MRI and post operative MRI (within 48 h from surgery) showing gross total ressection of the lesion (total ressection of solid portion of glioblastoma), between january 2009 and december 2012.

    Results: When compared the final anatomopathologic result with samples only from solid portion there was no difference. When we compared the anatomopathological findings between solid and infiltrative portions there was difference. The GFAP expression is the same in samples from both portions which characterize glial neoplasms. But the expression of p53, CD34, VEGF and Ki67 was more intense at solid portion than at infiltrative portion.

    Conclusions: We showed that the difference seen at macroscopy and image studies are also reflected on the expression of cellular and vascular immunohistochemical markers. And more, that expression is more intense in solid portion than the infiltrative portion.

    Patient Care: Pointing targets for future treatments in glioblastoma to increase overall survival and specially disease free survival.

    Learning Objectives: Show the increasing role of immunohistochemistry in glioblastoma different portions, as a potential targets for future treatments.

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