MURAGAKI Yoshihiro
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Visiting Professor
Article types Original article
Language English
Peer review Non peer reviewed
Title A surgical strategy for lower grade gliomas using intraoperative molecular diagnosis.
Journal Formal name：Brain tumor pathology
Abbreviation：Brain Tumor Pathol
ISSN code：14337398
Domestic / ForeginForegin
Volume, Issue, Page 35(3),pp.159-167
Author and coauthor KORIYAMA Shunichi†, NITTA Masayuki, KOBAYASHI Tatsuya, MURAGAKI Yoshihiro, SUZUKI Akane, MARUYAMA Takashi, KOMORI Takashi, MASUI Kenta, SAITO Taiichi, YASUDA Takayuki, HOSONO Junji, OKAMOTO Saori, SHIOYAMA Takahiro, YAMATANI Hiroaki, KAWAMATA Takakazu
Publication date 2018/07
Summary Lower grade gliomas are both treated and diagnosed via surgical resection. Maximum tumor resection is currently the standard of care; however, this risks the loss of brain function. Glioma can be genetically subdivided into three different types, based on isocitrate dehydrogenase (IDH) mutation status and the presence of 1p/19q codeletion, which have radically different prognoses and responses to adjuvant therapies. Therefore, the means to identify the subtype and evaluate the surrounding tissues during surgery would be advantageous. In this study, we have developed a new surgical strategy for lower grade glioma based on the fourth edition of the World Health Organization Brain Tumor Classification, involving intraoperative molecular diagnosis. High-resolution melting analysis was used to evaluate IDH mutational status, while rapid immunohistochemistry of p53 and alpha-thalassemia/mental retardation syndrome X-linked (ATRX) was used to evaluate the 1p/19q codeletion status, allowing genetic classification during surgery. In addition, intraoperative flow cytometry was used to evaluate the surgical cavity for additional tumor lesions, allowing maximal resection while mitigating the risk of functional losses. This strategy allows the rapid intraoperative diagnosis and mapping of lower grade gliomas, and its clinical use could dramatically improve its prognosis.
DOI 10.1007/s10014-018-0324-1
PMID 29980868