title: Contrast enhancement pattern predicts poor survival for patients with non-WNT/SHH medulloblastoma tumours.
abstract: Recent studies revealed the biological heterogeneity of medulloblastoma, with the existence of at least four groups which are associated with several clinical and morphological features. We investigated for further correlations between molecular types, location of tumours, their contrast enhancement pattern and survival of patients. Altogether 76 tumours were analyzed and molecular subtypes were identified by immunohistochemistry using representative antibodies, detection of chromosome 6 monosomy and CTNNB1 mutation. The site of the tumour was assessed on diagnosis using Magnetic Resonance images and intra-operative surgical reports. In addition, the gadolinium enhancement pattern was also investigated in pre-treatment tumours. Cerebellar hemispheric location was associated with SHH tumours (p < 0.001), as opposed to midline location being typical for WNT and non-WNT/SHH tumours. Remarkably, for patients with non-WNT/SHH tumours, the extensive gadolinium enhancement pattern (present in >75% of tumour volume) predicted worse OS and EFS than for those with none/weak or heterogeneous enhancement (>10-75% of tumour volume), (both p < 0.001). Our analysis indicates that distribution of the medulloblastoma tumours location is related to the biological characteristics of tumour. Importantly, the enhancement pattern of the tumour may be a clinically useful prognostic marker for patients with non-WNT/SHH medulloblastomas.
authors: Department of Pathology, The Children's Memorial Health Institute, Av. Dzieci Polskich 20, 04-730, Warsaw, Poland, m.lastowska@czd.pl.
authors: Maria
authors: M
authors: Łastowska
authors: Elżbieta
authors: E
authors: Jurkiewicz
authors: Joanna
authors: J
authors: Trubicka
authors: Paweł
authors: P
authors: Daszkiewicz
authors: Monika
authors: M
authors: Drogosiewicz
authors: Katarzyna
authors: K
authors: Malczyk
authors: Wiesława
authors: W
authors: Grajkowska
authors: Ewa
authors: E
authors: Matyja
authors: Bożena
authors: B
authors: Cukrowska
authors: Maciej
authors: M
authors: Pronicki
authors: Marta
authors: M
authors: Perek-Polnik
authors: Danuta
authors: D
authors: Perek
authors: Bożenna
authors: B
authors: Dembowska-Bagińska
mesh_terms: D000293:Adolescent; D002528:Cerebellar Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D053823:Hedgehog Proteins / Q000378:metabolism*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007124:Immunoenzyme Techniques; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008527:Medulloblastoma / Q000378:metabolism / Q000401:mortality* / Q000473:pathology; D009154:Mutation / Q000235:genetics; D009367:Neoplasm Staging; D011379:Prognosis; D012333:RNA, Messenger / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015996:Survival Rate; D051153:Wnt Proteins / Q000378:metabolism*; D051176:beta Catenin / Q000235:genetics
chemical_list: C495270:CTNNB1 protein, human; D003287:Contrast Media; D053823:Hedgehog Proteins; D012333:RNA, Messenger; C509239:SHH protein, human; D051153:Wnt Proteins; D051176:beta Catenin