الفهرس 
GLIOSIS
Types of neuroglial cellsOnly 14 pages are availabe for public view
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Abstract
Glial tumors are the most common primary brain
tumors. They are derived from astrocytes, oligodendroglial
cells, and ependyma. The majority of glial tumors are
malignant.
The aim of our study is to evaluate retrospectively the
immunohistochemical expression of WT1in reactive and
neoplastic glial cells.
The material of this study included 55 cases of brain
biopsies, 45 cases of which were previously diagnosed as
glial tumors (astrocytomas, oligodendrogliomas and
ependymomas) and 10 cases as reactive brain tissue.
The cases were received at the Pathology Department
of Ain Shams University Hospitals during the period (2006-
2011). All cases were subjected to the following: Clinical
studies by reviewing the files of the patients regarding age,
sex and type of specimen. Histopathological re-examination
of H& E stained sections prepared from paraffin blocks at 5µ
thickness. Immunohistochemical staining of paraffin
embedded tissue sections for WT1 and assessment of the
stained slides.
Glioblastoma was the most common astrocytic tumor
in our study representing 36% of astrocytic tumors.
As regards the age of patients in this study, the mean
age of studied cases was 41.8 years.
As regards sex incidence, slight male predominance
was detected representing 51% with M:F ratio 1.1:1. As regards site of predilection most of cases were
located in the cerebral cortex representing 75% followed by
intraventricular and posterior fossa cases.
The histopathological results revealed 10 cases of
gliosis representing (18.2 %), 38 cases of astrocytic tumors
(69.1 %), 3 cases of oligodendroglioma (5.5%), while 4 cases
of ependymoma.
The 38 cases astrocytomas included glioblastoma
(grade IV) which was the most common grade representing
(52.6%) of astrocytomas, followed by anaplastic astrocytoma
grade III representing 18.4%, then Diffuse astrocytoma grade
II representing 15.8 %. The least common was pilocytic
astrocytoma grade I representing 13.2 %. Two cases of
oligodendroglioma were grade II(66.7%) and (33.3%) was
grade III. Three cases of ependymoma were grade II (75%)
and one case was grade III (25%).
As regards the immunohistochemical studies,
negativity of WT1 was detected in all of the 10 cases of
gliosis cases and positivity of WT1 was detected in all the
glial tumor cases (45/45, 100%).
The intensity of staining for WT1 was mild (score 1)
in 11/45 cases representing 24.4%, moderate (score 2) in
12/45 cases representing 26.6%, marked (score 3 and 4) in
22/45 cases representing 48.8 %.
There was a lower mean age among patients with
WT1 score 1 compared to other groups with higher WT1
score (p value=0.001).As regarding gender, there was no significant difference between males and females regarding
mean WT1 score (p value =0.4). There was higher WT1
expression among patients with tumors located in cerebral
cortex (33 cases) with mean WT1 2.52.
WT1 expression significantly correlated with the
grade of astrocytic tumours where it increased with the
increase of tumour grade. On comparing grades individually,
there was a significant difference of WT1 expression
between grade(I, IV) and (grade III, grade IV).
Oligodendroglioma cases showed diffuse WT1 expression
with no significant relationship between their grade and WT1
score, grade II scored 2 while grade III were scored 1 and 3.
Diffuse WT1 expression was also observed in ependymomas,
with no significant relationship between their grade and WT1
expression, grade II cases were score 1,3,4 while grade III
was score 1.