title: Malignant clinical features of anaplastic gliomas without IDH mutation.
abstract: BACKGROUND
  Diagnosis of WHO grade III anaplastic gliomas does not always correspond to its clinical outcome because of the isocitrate dehydrogenase (IDH) gene status. Anaplastic gliomas without IDH mutation result in a poor prognosis, similar to grade IV glioblastomas. However, the malignant features of anaplastic gliomas without IDH mutation are not well understood. The aim of this study was to examine anaplastic gliomas, in particular those without IDH mutation, with regard to their malignant features, recurrence patterns, and association with glioma stem cells.
  
  
  METHODS
  We retrospectively analyzed 86 cases of WHO grade III anaplastic gliomas. Data regarding patient characteristics, recurrence pattern, and prognosis were obtained from medical records. We examined molecular alterations such as IDH mutation, 1p19q loss, TP53 mutation, MGMT promoter methylation, Ki67 labeling index, and CD133, SOX2, and NESTIN expression.
  
  
  RESULTS
  Of the 86 patients with anaplastic gliomas, 58 carried IDH mutation, and 40 experienced recurrence. The first recurrence was local in 25 patients and distant in 15. Patients without IDH mutation exhibited significantly higher CD133 and SOX2 expression (P = .025 and .020, respectively) and more frequent distant recurrence than those with IDH mutation (P = .022).
  
  
  CONCLUSIONS
  Patients with anaplastic gliomas without IDH mutation experienced distant recurrence and exhibited glioma stem cell markers, indicating that this subset may share some malignant characteristics with glioblastomas.
authors: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan (I.S., Y.S., T.S., M.K., R.S., T.I., T.K., Y.Y., T.T.); Department of Public Health, Tohoku University School of Medicine, Sendai, Japan (T.W.); Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan (T.K.); Pathological Division, Tohoku University Hospital, Sendai, Japan (M.W.); Department of Pathology, Sendai Medical Center, Sendai, Japan (H.S.).
authors: Ichiyo
authors: I
authors: Shibahara
authors: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan (I.S., Y.S., T.S., M.K., R.S., T.I., T.K., Y.Y., T.T.); Department of Public Health, Tohoku University School of Medicine, Sendai, Japan (T.W.); Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan (T.K.); Pathological Division, Tohoku University Hospital, Sendai, Japan (M.W.); Department of Pathology, Sendai Medical Center, Sendai, Japan (H.S.).
authors: Yukihiko
authors: Y
authors: Sonoda
authors: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan (I.S., Y.S., T.S., M.K., R.S., T.I., T.K., Y.Y., T.T.); Department of Public Health, Tohoku University School of Medicine, Sendai, Japan (T.W.); Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan (T.K.); Pathological Division, Tohoku University Hospital, Sendai, Japan (M.W.); Department of Pathology, Sendai Medical Center, Sendai, Japan (H.S.).
authors: Takuhiro
authors: T
authors: Shoji
authors: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan (I.S., Y.S., T.S., M.K., R.S., T.I., T.K., Y.Y., T.T.); Department of Public Health, Tohoku University School of Medicine, Sendai, Japan (T.W.); Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan (T.K.); Pathological Division, Tohoku University Hospital, Sendai, Japan (M.W.); Department of Pathology, Sendai Medical Center, Sendai, Japan (H.S.).
authors: Masayuki
authors: M
authors: Kanamori
authors: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan (I.S., Y.S., T.S., M.K., R.S., T.I., T.K., Y.Y., T.T.); Department of Public Health, Tohoku University School of Medicine, Sendai, Japan (T.W.); Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan (T.K.); Pathological Division, Tohoku University Hospital, Sendai, Japan (M.W.); Department of Pathology, Sendai Medical Center, Sendai, Japan (H.S.).
authors: Ryuta
authors: R
authors: Saito
authors: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan (I.S., Y.S., T.S., M.K., R.S., T.I., T.K., Y.Y., T.T.); Department of Public Health, Tohoku University School of Medicine, Sendai, Japan (T.W.); Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan (T.K.); Pathological Division, Tohoku University Hospital, Sendai, Japan (M.W.); Department of Pathology, Sendai Medical Center, Sendai, Japan (H.S.).
authors: Tomoo
authors: T
authors: Inoue
authors: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan (I.S., Y.S., T.S., M.K., R.S., T.I., T.K., Y.Y., T.T.); Department of Public Health, Tohoku University School of Medicine, Sendai, Japan (T.W.); Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan (T.K.); Pathological Division, Tohoku University Hospital, Sendai, Japan (M.W.); Department of Pathology, Sendai Medical Center, Sendai, Japan (H.S.).
authors: Tomohiro
authors: T
authors: Kawaguchi
authors: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan (I.S., Y.S., T.S., M.K., R.S., T.I., T.K., Y.Y., T.T.); Department of Public Health, Tohoku University School of Medicine, Sendai, Japan (T.W.); Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan (T.K.); Pathological Division, Tohoku University Hospital, Sendai, Japan (M.W.); Department of Pathology, Sendai Medical Center, Sendai, Japan (H.S.).
authors: Yoji
authors: Y
authors: Yamashita
authors: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan (I.S., Y.S., T.S., M.K., R.S., T.I., T.K., Y.Y., T.T.); Department of Public Health, Tohoku University School of Medicine, Sendai, Japan (T.W.); Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan (T.K.); Pathological Division, Tohoku University Hospital, Sendai, Japan (M.W.); Department of Pathology, Sendai Medical Center, Sendai, Japan (H.S.).
authors: Takashi
authors: T
authors: Watanabe
authors: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan (I.S., Y.S., T.S., M.K., R.S., T.I., T.K., Y.Y., T.T.); Department of Public Health, Tohoku University School of Medicine, Sendai, Japan (T.W.); Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan (T.K.); Pathological Division, Tohoku University Hospital, Sendai, Japan (M.W.); Department of Pathology, Sendai Medical Center, Sendai, Japan (H.S.).
authors: Toshihiro
authors: T
authors: Kumabe
authors: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan (I.S., Y.S., T.S., M.K., R.S., T.I., T.K., Y.Y., T.T.); Department of Public Health, Tohoku University School of Medicine, Sendai, Japan (T.W.); Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan (T.K.); Pathological Division, Tohoku University Hospital, Sendai, Japan (M.W.); Department of Pathology, Sendai Medical Center, Sendai, Japan (H.S.).
authors: Mika
authors: M
authors: Watanabe
authors: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan (I.S., Y.S., T.S., M.K., R.S., T.I., T.K., Y.Y., T.T.); Department of Public Health, Tohoku University School of Medicine, Sendai, Japan (T.W.); Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan (T.K.); Pathological Division, Tohoku University Hospital, Sendai, Japan (M.W.); Department of Pathology, Sendai Medical Center, Sendai, Japan (H.S.).
authors: Hiroyoshi
authors: H
authors: Suzuki
authors: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan (I.S., Y.S., T.S., M.K., R.S., T.I., T.K., Y.Y., T.T.); Department of Public Health, Tohoku University School of Medicine, Sendai, Japan (T.W.); Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan (T.K.); Pathological Division, Tohoku University Hospital, Sendai, Japan (M.W.); Department of Pathology, Sendai Medical Center, Sendai, Japan (H.S.).
authors: Teiji
authors: T
authors: Tominaga
mesh_terms: D000071916:AC133 Antigen; D000328:Adult; D015703:Antigens, CD / Q000378:metabolism; D001932:Brain Neoplasms / Q000235:genetics* / Q000378:metabolism; D005260:Female; D005910:Glioma / Q000235:genetics* / Q000378:metabolism; D006023:Glycoproteins / Q000378:metabolism; D006801:Humans; D007521:Isocitrate Dehydrogenase / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D060787:Neoplasm Grading; D010455:Peptides / Q000378:metabolism; D055748:SOXB1 Transcription Factors / Q000378:metabolism
chemical_list: D000071916:AC133 Antigen; D015703:Antigens, CD; D006023:Glycoproteins; C000606023:PROM1 protein, human; D010455:Peptides; C527782:SOX2 protein, human; D055748:SOXB1 Transcription Factors; D007521:Isocitrate Dehydrogenase; C543588:IDH1 protein, human
keywords: CD133; IDH; anaplastic gliomas; distant recurrence; grade III gliomas