title: Nogo-a expression in glial CNS tumors: a tool to differentiate between oligodendrogliomas and other gliomas?
abstract: Gliomas are the most frequent primary brain tumors. In a minority of cases, the differentiation between astrocytomas and oligodendrogliomas based on morphologic characteristics alone can be difficult; though it is important, as patients with oligodendrogliomas follow a more favorable clinical course. Here we report on the immunohistochemical expression pattern of the oligodendrocytic marker Nogo-A in 113 central nervous system tumors including 28 oligodendrogliomas [15, World Health Organization (WHO) grade II; 13, grade WHO III], 50 astrocytomas [10, grade WHO II; 11, grade WHO III; 29 glioblastoma multiforme (GBM)], 11 ependymomas WHO grade II, 7 central neurocytomas, 2 dysembryoplastic neuroepithelial tumors (DNTs), 5 clear cell meningiomas, and 10 metastases to the brain. The oligodendrocytic marker Nogo-A was found to be strongly expressed in 71% of oligodendrogliomas, but in 0% of ependymomas WHO grade II, astrocytomas WHO grade II or III, DNTs, central neurocytomas, or clear cell meningiomas. In GBM, a subgroup of tumors (24%) showed strong expression of Nogo-A coincidently with Ki67 positivity but glial fibrillary acidic protein-negativity. However, neither in oligodendrogliomas nor GBM was a correlation between the loss of 1p19q and the extent of Nogo-A expression observed. Our findings indicate that Nogo-A is strongly expressed in the majority of oligodendrogliomas and might be a helpful marker to distinguish oligodendrogliomas from astrocytomas WHO grades II and III as well as ependymomas. They also support the hypothesis that GBM may be a heterogeneous group of tumors derived from different progenitor cells.
authors.affiliation: Institute of Neuropathology, University Hospital Münster, Münster, Germany. tanjakuhlmann@gmx.de
authors.forename: Tanja
authors.initials: T
authors.lastname: Kuhlmann
authors.forename: Angelika
authors.initials: A
authors.lastname: Gutenberg
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Schulten
authors.forename: Werner
authors.initials: W
authors.lastname: Paulus
authors.forename: Veit
authors.initials: V
authors.lastname: Rohde
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Bruck
mesh_terms: D001254:Astrocytoma / Q000737:chemistry; D014408:Biomarkers, Tumor / Q000032:analysis*; D001932:Brain Neoplasms / Q000737:chemistry* / Q000235:genetics / Q000473:pathology; D003937:Diagnosis, Differential; D004806:Ependymoma / Q000737:chemistry; D015972:Gene Expression Regulation, Neoplastic; D005909:Glioblastoma / Q000737:chemistry; D005910:Glioma / Q000737:chemistry* / Q000235:genetics / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008579:Meningioma / Q000737:chemistry* / Q000235:genetics / Q000473:pathology; D009185:Myelin Proteins / Q000032:analysis*; D009367:Neoplasm Staging; D018306:Neurocytoma / Q000737:chemistry* / Q000235:genetics / Q000473:pathology; D000070798:Nogo Proteins; D009837:Oligodendroglioma / Q000737:chemistry* / Q000235:genetics / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D009185:Myelin Proteins; D000070798:Nogo Proteins; C000603199:RTN4 protein, human