Manocha Aakriti, Jain Sunila
Department of Pathology, Sir Ganga Ram Hospital, New Delhi, India.
Indian J Cancer. 2019 Jul-Sep;56(3):197-201. doi: 10.4103/ijc.IJC_51_18.
Wilms' tumor 1 (WT1) mutation has recently been detected in gliomas. Growing data indicate that WT1 mutation plays a causal role in gliomagenesis and is overexpressed in most glioblastomas. An emerging immunotherapy targeting WT1 has shown to be effective in resistant glioblastomas in clinical trials. WT1 expression and its potential utility in various grades of astrocytomas is still unclear and needs further elucidation. The evaluation of WT1 can be done by molecular or immunohistochemical methods. As immunohistochemistry is easier with wider routine use, immunoexpression of this biomarker was studied.
The aim of this study was to characterize WT1 immunoexpression across different histological grades of astrocytomas to routinely aid in diagnosis and reproducibility and to assess the association between WT1 and immunomarker isocitrate dehydrogenase (IDH1).
This was an observational prospective study on 79 cases of astrocytomas.
Seventy-nine astrocytomas including 11 recurrent tumors were assessed for WT1 by immunohistochemistry. WT1 expression was detected in all astrocytomas (100%). The control group of reactive gliosis was negative. WT1 score correlated with histological tumor grades (P < 0.001) with higher score in higher grade. It was also observed that different tumor grades depicted two distinct expression patterns. WT1 score and pattern were valuable in differentiating high- and low-grade astrocytomas.
This study supports the oncogenic role of WT1 in astrocytomas. WT1 was found to be valuable in distinguishing different grades of astrocytomas. WT1 can aid in differentiating neoplastic process from reactive gliosis, particularly in recurrent tumors. Higher expression in glioblastomas supports its immunotherapy potential.
最近在胶质瘤中检测到威尔姆斯瘤1（WT1）突变。越来越多的数据表明，WT1突变在胶质瘤发生中起因果作用，并且在大多数胶质母细胞瘤中过表达。一种新兴的针对WT1的免疫疗法在临床试验中已显示对耐药胶质母细胞瘤有效。WT1在不同级别的星形细胞瘤中的表达及其潜在用途仍不清楚，需要进一步阐明。WT1的评估可以通过分子或免疫组织化学方法进行。由于免疫组织化学操作更简便且常规应用更广泛，因此对该生物标志物的免疫表达进行了研究。
本研究的目的是表征WT1在不同组织学分级的星形细胞瘤中的免疫表达，以便在常规诊断中提供帮助并提高可重复性，并评估WT1与免疫标志物异柠檬酸脱氢酶（IDH1）之间的关联。
这是一项对79例星形细胞瘤的观察性前瞻性研究。
通过免疫组织化学对79例星形细胞瘤（包括11例复发性肿瘤）进行了WT1评估。在所有星形细胞瘤中均检测到WT1表达（100%）。反应性胶质增生的对照组为阴性。WT1评分与肿瘤组织学分级相关（P < 0.001），分级越高评分越高。还观察到不同肿瘤分级呈现两种不同的表达模式。WT1评分和模式在区分高级别和低级别星形细胞瘤方面具有重要价值。
本研究支持WT1在星形细胞瘤中的致癌作用。发现WT1在区分不同级别的星形细胞瘤方面具有重要价值。WT1有助于将肿瘤性病变与反应性胶质增生区分开来，特别是在复发性肿瘤中。在胶质母细胞瘤中较高的表达支持了其免疫治疗潜力。
