Immunohistochemical analysis of IDH1, ATRX, p53, and Ki-67 in glioblastoma and diffuse infiltrative glioma: Therapeutic and prognostic correlation

Background/Aim. The most common molecular alterations in high-grade astrocytoma include mutation of the isocitrate dehydrogenase (IDH) gene, loss of 1p19q, and p53 mutation. The aim of the study was to determine the prevalence of high-grade astrocytoma and glioblastoma and to examine the immunohisto...

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Main Authors: Hasbay Bermal, Kayaselçuk Fazilet, Süner Halil İbrahim, Tufan Kadir
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2025-01-01
Series:Vojnosanitetski Pregled
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Online Access:https://doiserbia.nb.rs/img/doi/0042-8450/2025/0042-84502500042H.pdf
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author Hasbay Bermal
Kayaselçuk Fazilet
Süner Halil İbrahim
Tufan Kadir
author_facet Hasbay Bermal
Kayaselçuk Fazilet
Süner Halil İbrahim
Tufan Kadir
author_sort Hasbay Bermal
collection DOAJ
description Background/Aim. The most common molecular alterations in high-grade astrocytoma include mutation of the isocitrate dehydrogenase (IDH) gene, loss of 1p19q, and p53 mutation. The aim of the study was to determine the prevalence of high-grade astrocytoma and glioblastoma and to examine the immunohistochemical staining patterns of IDH1, alpha-thalassemia/mental retardation X-linked (ATRX), p53, and Ki-67, as well as neoplastic morphological findings, treatment response, and effects on prognosis. Methods. Patients with IDH-mutant or IDH-wild-type glial tumors diagnosed at our center between January 2016 and January 2022 were included in the study. Patients were divided into groups according to age as follows: 7–40, 41–55, 56–64, and ≥ 65 years. The impact of demographic and clinical features on survival was analyzed. The effects of IDH1, p53, ATRX, and Ki-67 parameters on treatment success and prognosis were investigated. The Chi-square test was used to compare independent categorical variables, while the McNemar test was used for dependent categorical variables between the groups. Kaplan-Meier method and Cox proportional regression model (forward model) were used to estimate the mean and median survival times, failure rates, and hazard ratios. Results. In the study, 115 (56.1%) patients were male and 90 (43.9%) were female. The patients ranged in age from 7 to 84 years. There was no significant relationship between gender and age groups on survival (p = 0.113). However, there was a significant association between the glioblastoma grade and survival (p = 0.024). There were 65 (31.7%) patients who died. The mean overall survival of all patients was 45.2 months (median: 24 months). While 45 (21.2%) patients were found to have IDH1 mutation, the number of patients negative for the mutation was 160 (78.8%). Overall survival was significantly longer in IDH1-positive patients (mean: 65.8, median: 80) than in IDH1-negative patients (mean: 25.7, median: 22) (p = 0.019). Conclusion. It was found that mutations of IDH1 and ATRX and overexpression of p53 alone significantly impacted the prognosis of glioblastoma patients. However, radiotherapy and chemotherapy had a positive effect on patient survival. Survival can be increased by adding additional treatments to patients with ATRX mutations.
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spelling doaj-art-3be86414ec3447f083bbef732b7fa70a2025-08-20T03:58:14ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202025-01-0182741342310.2298/VSP241008042H0042-84502500042HImmunohistochemical analysis of IDH1, ATRX, p53, and Ki-67 in glioblastoma and diffuse infiltrative glioma: Therapeutic and prognostic correlationHasbay Bermal0Kayaselçuk Fazilet1Süner Halil İbrahim2Tufan Kadir3Baskent University, Faculty of Medicine, Department of Pathology, Adana, Türkiye + Baskent University, Faculty of Medicine, Ankara Hospital, Department of Pathology, Ankara, Türkiye Baskent University, Faculty of Medicine, Ankara Hospital, Department of Pathology, Ankara, TürkiyeBaskent University, Faculty of Medicine, Department of Neurosurgery, Adana Dr. Turgut Noyan Application and Research Center, Adana, TürkiyeBaskent University, Faculty of Medicine, Department of Neurosurgery, Adana Dr. Turgut Noyan Application and Research Center, Adana, TürkiyeBackground/Aim. The most common molecular alterations in high-grade astrocytoma include mutation of the isocitrate dehydrogenase (IDH) gene, loss of 1p19q, and p53 mutation. The aim of the study was to determine the prevalence of high-grade astrocytoma and glioblastoma and to examine the immunohistochemical staining patterns of IDH1, alpha-thalassemia/mental retardation X-linked (ATRX), p53, and Ki-67, as well as neoplastic morphological findings, treatment response, and effects on prognosis. Methods. Patients with IDH-mutant or IDH-wild-type glial tumors diagnosed at our center between January 2016 and January 2022 were included in the study. Patients were divided into groups according to age as follows: 7–40, 41–55, 56–64, and ≥ 65 years. The impact of demographic and clinical features on survival was analyzed. The effects of IDH1, p53, ATRX, and Ki-67 parameters on treatment success and prognosis were investigated. The Chi-square test was used to compare independent categorical variables, while the McNemar test was used for dependent categorical variables between the groups. Kaplan-Meier method and Cox proportional regression model (forward model) were used to estimate the mean and median survival times, failure rates, and hazard ratios. Results. In the study, 115 (56.1%) patients were male and 90 (43.9%) were female. The patients ranged in age from 7 to 84 years. There was no significant relationship between gender and age groups on survival (p = 0.113). However, there was a significant association between the glioblastoma grade and survival (p = 0.024). There were 65 (31.7%) patients who died. The mean overall survival of all patients was 45.2 months (median: 24 months). While 45 (21.2%) patients were found to have IDH1 mutation, the number of patients negative for the mutation was 160 (78.8%). Overall survival was significantly longer in IDH1-positive patients (mean: 65.8, median: 80) than in IDH1-negative patients (mean: 25.7, median: 22) (p = 0.019). Conclusion. It was found that mutations of IDH1 and ATRX and overexpression of p53 alone significantly impacted the prognosis of glioblastoma patients. However, radiotherapy and chemotherapy had a positive effect on patient survival. Survival can be increased by adding additional treatments to patients with ATRX mutations.https://doiserbia.nb.rs/img/doi/0042-8450/2025/0042-84502500042H.pdfastrocytomaglioblastomaımmunohistochemistrymutationneoplasm gradingsurvival
spellingShingle Hasbay Bermal
Kayaselçuk Fazilet
Süner Halil İbrahim
Tufan Kadir
Immunohistochemical analysis of IDH1, ATRX, p53, and Ki-67 in glioblastoma and diffuse infiltrative glioma: Therapeutic and prognostic correlation
Vojnosanitetski Pregled
astrocytoma
glioblastoma
ımmunohistochemistry
mutation
neoplasm grading
survival
title Immunohistochemical analysis of IDH1, ATRX, p53, and Ki-67 in glioblastoma and diffuse infiltrative glioma: Therapeutic and prognostic correlation
title_full Immunohistochemical analysis of IDH1, ATRX, p53, and Ki-67 in glioblastoma and diffuse infiltrative glioma: Therapeutic and prognostic correlation
title_fullStr Immunohistochemical analysis of IDH1, ATRX, p53, and Ki-67 in glioblastoma and diffuse infiltrative glioma: Therapeutic and prognostic correlation
title_full_unstemmed Immunohistochemical analysis of IDH1, ATRX, p53, and Ki-67 in glioblastoma and diffuse infiltrative glioma: Therapeutic and prognostic correlation
title_short Immunohistochemical analysis of IDH1, ATRX, p53, and Ki-67 in glioblastoma and diffuse infiltrative glioma: Therapeutic and prognostic correlation
title_sort immunohistochemical analysis of idh1 atrx p53 and ki 67 in glioblastoma and diffuse infiltrative glioma therapeutic and prognostic correlation
topic astrocytoma
glioblastoma
ımmunohistochemistry
mutation
neoplasm grading
survival
url https://doiserbia.nb.rs/img/doi/0042-8450/2025/0042-84502500042H.pdf
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