Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Asian Pac J Cancer Prev. 2020 Aug 1;21(8):2403-2413. doi: 10.31557/APJCP.2020.21.8.2403.
This tissue microarray (TMA) immunohistochemical (IHC) study elucidates the role of Wilms' tumor 1 protein (WT1) in diagnosis and prognostication of astrocytic tumors.
IHC was applied to 75 astrocytic lesions (18 astrogliosis and 57 astrocytic tumors) using antibodies directed against WT1 clone 6F-H2, isocitrate dehydrogenase 1(IDH1), Bcl2 and Ki67. WT1 IHC staining was evaluated and scored blindly by 2 pathologists. Bcl2 and Ki67 scores and labelling indices were assessed and IDH1 status determined. Statistical analysis was performed using the appropriate methodology.
WT1 cytoplasmic expression was detected in 89.5% of astrocytic tumors but not in astrogliosis. Positive WT1 differentiated astrocytic tumors (92.6% accuracy) and grade II diffuse astrocytomas (93.5% accuracy) from astrogliosis with high sensitivity, specificity and positive predictive values (p<0.001). Increased WT1 score significantly associated higher Bcl2 and Ki67 labelling indices, increasing WHO tumor grade and tumor's histopathologic type (p<0.05) showing staining pattern variability by tumor entity and cell type. Glioblastomas, gliosarcomas and subependymal giant cell astrocytomas were the most frequently WT1 expressing tumors with frequent +3 WT1 score. About 21.4% of pilocytic astrocytomas had +3WT1 score in association with increased Bcl2 and Ki67 indices. Low WT1 scores in grade II and III diffuse astrocytomas were linked to the high frequency of IDH1 positivity, and were associated with low Bcl2 and Ki67 labelling indices. In glioblastomas, WT1 significantly associated poor prognostic variables: older age, negative-IDH1 status, high Bcl2 and Ki67 labelling indices (p=0.04, <0.001, =0.001 and.
本组织微阵列（TMA）免疫组织化学（IHC）研究阐明了 Wilms 肿瘤 1 蛋白（WT1）在星形细胞瘤诊断和预后中的作用。
使用针对 WT1 克隆 6F-H2、异柠檬酸脱氢酶 1（IDH1）、Bcl2 和 Ki67 的抗体，对 75 例星形细胞病变（18 例星形细胞增生和 57 例星形细胞瘤）进行 IHC。由 2 位病理学家对 WT1 IHC 染色进行盲法评估和评分。评估 Bcl2 和 Ki67 评分和标记指数，并确定 IDH1 状态。使用适当的方法进行统计分析。
WT1 细胞质表达在 89.5%的星形细胞瘤中检测到，但在星形细胞增生中未检测到。阳性 WT1 可区分星形细胞瘤（92.6%的准确率）和 II 级弥漫性星形细胞瘤（93.5%的准确率）与星形细胞增生，具有高灵敏度、特异性和阳性预测值（p<0.001）。WT1 评分增加与更高的 Bcl2 和 Ki67 标记指数显著相关，增加了 WHO 肿瘤分级和肿瘤的组织病理学类型（p<0.05），显示出肿瘤实体和细胞类型的染色模式变异性。胶质母细胞瘤、胶质肉瘤和室管膜下巨细胞星形细胞瘤是最常表达 WT1 的肿瘤，且常出现+3 WT1 评分。约 21.4%的毛细胞星形细胞瘤具有+3WT1 评分，同时伴有 Bcl2 和 Ki67 指数增加。II 级和 III 级弥漫性星形细胞瘤中低 WT1 评分与 IDH1 阳性的高频率相关，并与低 Bcl2 和 Ki67 标记指数相关。在胶质母细胞瘤中，WT1 与不良预后变量显著相关：年龄较大、IDH1 状态阴性、高 Bcl2 和 Ki67 标记指数（p=0.04，<0.001，=0.001 和.
