title: Alterations of cell cycle regulators in gliomatosis cerebri.
abstract: Gliomatosis cerebri (GC) is regarded as a rare glial neoplasm of unknown origin, and a detailed analysis of molecular alterations underlying this disease has started only recently. However, because GC characteristically affects large parts of the brain and spinal cord, the distribution of genetic alterations may be highly variable between different tumor areas. Additionally, tumor areas with varying degrees of differentiation may be present, raising the possibility to model the genetic events associated with astrocytoma progression. Here we analyzed various tumor regions with features of low-grade and high-grade astrocytomas from 9 autopsy-proven GC cases for the immunoexpression of the cell cycle-controlling proteins mdm2, p21, p27/kip1, p16, and Rb. The samples were also screened for EGFR expression, and for amplification of the EGFR and MDM2 genes. Furthermore, allelic losses of the CDKN2A gene and of a PTEN flanking region of chromosome 10 were determined. We detected tumor regions with immunoexpression of p21 only rarely in our series, without association to the tumor grade. No MDM2 gene amplification was detected. In contrast, three cases demonstrated maintained Rb expression. The expression of p27(kip1) showed a clear reduction with increasing astrocytoma malignancy in 7 cases. Allelic loss of the CDKN2A gene occurred in 5 patients but was not related to the tumor grading, nor to the intensity of p16 immunoexpression. No homozygous CDKN2Adeletions were detected. EGFR amplification was also absent in our series, but one case demonstrated EGFR expression only in the high-grade tumor area. Allelic losses on chromosome 10 were found in one out of six informative cases. However, marked differences in the immunoexpression, as well as in the distribution of genetic aberrations were seen between different tumor samples within a given case. The distribution of the alterations suggests that these molecular genetic changes represent secondary events, which may develop within tumor clones derived from a common founder tumor clone characterized by extraordinary spreading through the brain. Moreover, the detected aberrations in gliomatosis cerebri can reflect the tumor progression associated with secondary malignant astrocytoma formation even within a single case.
authors.affiliation: Institut für Neuropathologie, Otto-von-Guericke-Universität, Leipziger Strasse 44, D-39120, Magdeburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Mawrin
authors.forename: Elmar
authors.initials: E
authors.lastname: Kirches
authors.forename: Regine
authors.initials: R
authors.lastname: Schneider-Stock
authors.forename: Carsten
authors.initials: C
authors.lastname: Boltze
authors.forename: Christian K
authors.initials: CK
authors.lastname: Vorwerk
authors.forename: Andreas
authors.initials: A
authors.lastname: von Mawrin
authors.forename: Elmar
authors.initials: E
authors.lastname: Kirches
authors.forename: Regine
authors.initials: R
authors.lastname: Schneider-Stock
authors.forename: Carsten
authors.initials: C
authors.lastname: Boltze
authors.forename: Christian K
authors.initials: CK
authors.lastname: Vorwerk
authors.forename: Andreas
authors.initials: A
authors.lastname: von Mawrin
authors.forename: Elmar
authors.initials: E
authors.lastname: Kirches
authors.forename: Regine
authors.initials: R
authors.lastname: Schneider-Stock
authors.forename: Carsten
authors.initials: C
authors.lastname: Boltze
authors.forename: Christian K
authors.initials: CK
authors.lastname: Vorwerk
authors.forename: Andreas
authors.initials: A
authors.lastname: von Mawrin
authors.forename: Elmar
authors.initials: E
authors.lastname: Kirches
authors.forename: Regine
authors.initials: R
authors.lastname: Schneider-Stock
authors.forename: Carsten
authors.initials: C
authors.lastname: Boltze
authors.forename: Christian K
authors.initials: CK
authors.lastname: Vorwerk
authors.forename: Andreas
authors.initials: A
authors.lastname: von Deimling
authors.forename: Gisela
authors.initials: G
authors.lastname: Stoltenburg-Didinge
authors.forename: Antje
authors.initials: A
authors.lastname: Bornemann
authors.forename: Bernd
authors.initials: B
authors.lastname: Romeike
authors.forename: Bernd
authors.initials: B
authors.lastname: Sellhaus
authors.forename: Knut
authors.initials: K
authors.lastname: Dietzmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D001932:Brain Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000473:pathology*; D018797:Cell Cycle Proteins / Q000235:genetics* / Q000378:metabolism; D002879:Chromosomes, Human, Pair 10 / Q000235:genetics*; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000235:genetics / Q000378:metabolism; D004247:DNA / Q000032:analysis; D066246:ErbB Receptors / Q000235:genetics / Q000378:metabolism; D005260:Female; D005784:Gene Amplification; D015972:Gene Expression Regulation, Neoplastic / Q000235:genetics / Q000502:physiology; D006801:Humans; D007150:Immunohistochemistry; D019656:Loss of Heterozygosity / Q000235:genetics; D008297:Male; D008875:Middle Aged; D018302:Neoplasms, Neuroepithelial / Q000235:genetics* / Q000378:metabolism / Q000473:pathology*; D009687:Nuclear Proteins / Q000235:genetics / Q000378:metabolism; D011518:Proto-Oncogene Proteins / Q000235:genetics / Q000378:metabolism; D051736:Proto-Oncogene Proteins c-mdm2
chemical_list: D018797:Cell Cycle Proteins; D019941:Cyclin-Dependent Kinase Inhibitor p16; D009687:Nuclear Proteins; D011518:Proto-Oncogene Proteins; D004247:DNA; C497206:MDM2 protein, human; D051736:Proto-Oncogene Proteins c-mdm2; D066246:ErbB Receptors