Molecular Aberrations Associated with Seizure Control in Diffuse Astrocytic and Oligodendroglial Tumors
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- SUZUKI Hime
- Department of Neurosurgery, Sapporo Medical University
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- MIKUNI Nobuhiro
- Department of Neurosurgery, Sapporo Medical University
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- SUGITA Shintaro
- Department of Surgical Pathology, Sapporo Medical University
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- AOYAMA Tomoyuki
- Department of Surgical Pathology, Sapporo Medical University
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- YOKOYAMA Rintaro
- Department of Neurosurgery, Sapporo Medical University
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- SUZUKI Yuto
- Department of Neurosurgery, Sapporo Medical University
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- ENATSU Rei
- Department of Neurosurgery, Sapporo Medical University
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- AKIYAMA Yukinori
- Department of Neurosurgery, Sapporo Medical University
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- MIKAMI Takeshi
- Department of Neurosurgery, Sapporo Medical University
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- WANIBUCHI Masahiko
- Department of Neurosurgery, Sapporo Medical University
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- HASEGAWA Tadashi
- Department of Surgical Pathology, Sapporo Medical University
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Abstract
<p>Diffuse astrocytic and oligodendroglial tumors are frequently associated with symptomatic epilepsy, and predictive seizure control is important for the improvement of patient quality of life. To elucidate the factors related to drug resistance of brain tumor-associated epilepsy from a pathological perspective. From January 2012 to October 2017, 36 patients diagnosed with diffuse astrocytic or oligodendroglial tumors were included. Assessment for seizure control was performed according to the Engel classification of seizures. Patient clinical, radiological, and pathological data were stratified based on the following 16 variables: age, sex, location of tumor, existence of the preoperative seizure, extent of resection, administration of temozolomide, radiation therapy, recurrence, Karnofsky performance scale, isocitrate dehydrogenase 1, 1p/19q co-deletion, Olig2, platelet-derived growth factor receptor alpha, p53, ATRX, and Ki67. These factors were compared between the well-controlled group and drug-resistant seizure group. Twenty-seven patients experienced seizures; of these, 14 cases were well-controlled, and 13 cases were drug-resistant. Neither clinical nor radiological characteristics were significantly different between these two groups, though p53 immunodetection levels were significantly higher, and the frequency of 1p/19q co-deletion was significantly lower in the group with drug-resistant seizures than in the well-controlled group. In the multivariate analysis, only one item was selected according to stepwise methods, and a significant difference was observed for p53 (OR, 21.600; 95% CI, 2.135–218.579; P = 0.009). Upregulation of p53 may be a molecular mechanism underlying drug resistant epilepsy associated with diffuse astrocytic and oligodendroglial tumors.</p>
Journal
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- Neurologia medico-chirurgica
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Neurologia medico-chirurgica 60 (3), 147-155, 2020
The Japan Neurosurgical Society
