Summary

Many advances have been made in evaluating the molecular genetics of gliomas. For example, the presence of 1p and 19q deletions is associated with gliomas of oligoden-droglial lineage, with oligodendrogliomas that have a better survival and with oligodendrogliomas that respond to chemotherapy and radiation therapy. While prospective data are needed to confirm these associations, 1p and 19q deletion testing has become a part of routine neurooncol-ogy practice. Alterations of chromosome 10, EGFR, PTEN, and TP53 are associated with different grades of astrocytic gliomas and with patient survival. While their clinical utility requires further investigation, these markers (and others) will be increasingly used to stratify patients to current and new therapeutic approaches. In the future, it is likely that the survival rate of primary gliomas will be lengthened using biologically based treatment options linked with specific diagnostic biomarker profiles.

Anaplastic oligodendroglioma with loss of 1p and 19q

1q24 copy

19p13 copy

1p36 copy number

1p36 copy number

1q24 copy

19p13 copy

0

1

2

3

4

Total

0

0

0

0

0

0

0

1

0

17

1

0

0

18

2

0

70

12

0

0

82

3

0

0

0

0

0

0

4

0

0

0

0

0

0

Total

0

87

13

0

0

100

19q13.3 copy number

0

1

2

3

4

Total

0

0

0

0

0

0

0

1

0

24

0

0

0

24

2

0

51

23

0

0

74

3

0

0

1

1

0

2

4

0

0

0

0

0

0

Total

0

75

24

1

0

100

1q 1q

24

1p/

1q ratio: 0.62

19q13.3 19q13

19q/19p ratio: 0.71

Anaplastic oligodendroglioma without loss of 1p and 19q

1p36 copy number

0

1

2

3

4

Total

1q24

0

0

0

0

0

0

0

copy

1

0

15

11

0

0

26

number

2

0

6

57

4

0

67

3

0

0

1

5

0

6

4

0

0

0

0

1

1

Total

0

21

69

9

1

100

19q13.3 copy number

0

1

2

3

4

Total

0

0

0

0

0

0

0

19p13

copy

1

U

13

8

0

0

21

number

2

0

6

66

0

0

72

3

0

0

0

6

0

6

4

0

0

0

0

1

1

Total

0

19

74

6

1

19q13.3 19p13

19q/19p ratio: 1.01

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v./, v.

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i

y*

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.

*

>> r< i >

% a

» V

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V

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Vf;

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3ft

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Figure 27-2. Representative histology and FISH results for two primary grade 3 anaplastic oligodendrogliomas. (a) An anaplastic oligodendroglioma with 1p and 19q deletion. (b) An anaplastic oligodendroglioma without 1p and 19q deletion. The values in the tables summarize the percent nuclei with the indicated number of 1p36 and 1q24 or 19p13 and 19q13.3 signals.

1p36 1q24

0 0

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