title: ATRX, IDH1-R132H and Ki-67 immunohistochemistry as a classification scheme for astrocytic tumors.
abstract: Recurrence and progression to higher grade lesions are key biological events and characteristic behaviors in the evolution process of glioma. Malignant astrocytic tumors such as glioblastoma (GBM) are the most lethal intracranial tumors. However, the clinical practicability and significance of molecular parameters for the diagnostic and prognostic prediction of astrocytic tumors is still limited. In this study, we detected ATRX, IDH1-R132H and Ki-67 by immunohistochemistry and observed the association of IDH1-R132H with ATRX and Ki-67 expression. There was a strong association between ATRX loss and IDH1-R132H (p<0.0001). However, Ki-67 high expression restricted in the tumors with IDH1-R132H negative (p=0.0129). Patients with IDH1-R132H positive or ATRX loss astrocytic tumors had a longer progressive- free survival (p<0.0001, p=0.0044, respectively). High Ki-67 expression was associated with shorter PFS in patients with astrocytic tumors (p=0.002). Then we characterized three prognostic subgroups of astrocytic tumors (referred to as A1, A2 and A3). The new model demonstrated a remarkable separation of the progression interval in the three molecular subgroups and the distribution of patients' age in the A1-A2-A3 model was also significant different. This model will aid predicting the overall survival and progressive time of astrocytic tumors' patients.
authors.affiliation: Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, NanGang District, Harbin, Heilongjiang Province 150001, China.|Chinese Glioma Cooperative Group (CGCG), Dongcheng District, Beijing 100050, China.
authors.forename: Jinquan
authors.initials: J
authors.lastname: Cai
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Dongcheng District, Beijing 100050, China.|Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing 100050, China.
authors.forename: Chuanbao
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Dongcheng District, Beijing 100050, China.|Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing 100050, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, NanGang District, Harbin, Heilongjiang Province 150001, China.|Chinese Glioma Cooperative Group (CGCG), Dongcheng District, Beijing 100050, China.
authors.forename: Guangzhi
authors.initials: G
authors.lastname: Wang
authors.affiliation: Chinese Glioma Cooperative Group (CGCG), Dongcheng District, Beijing 100050, China.|Department of Pathology, Sanbo Brain Hospital, Capital Medical University, Haidian District, Beijing 100093, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Yao
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing 100050, China.|Chinese Glioma Cooperative Group (CGCG), Dongcheng District, Beijing 100050, China.
authors.forename: Zhiliang
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Dongcheng District, Beijing 100050, China.|Chinese Glioma Cooperative Group (CGCG), Dongcheng District, Beijing 100050, China.
authors.forename: Guanzhang
authors.initials: G
authors.lastname: Li
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Dongcheng District, Beijing 100050, China.|Chinese Glioma Cooperative Group (CGCG), Dongcheng District, Beijing 100050, China.
authors.forename: Zenghui
authors.initials: Z
authors.lastname: Qian
authors.affiliation: Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, NanGang District, Harbin, Heilongjiang Province 150001, China.|Chinese Glioma Cooperative Group (CGCG), Dongcheng District, Beijing 100050, China.
authors.forename: Yongli
authors.initials: Y
authors.lastname: Li
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Dongcheng District, Beijing 100050, China.|Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing 100050, China.|Beijing Institute for Brain Disorders Brain Tumor Center, Dongcheng District, Beijing 100050, China.|China National Clinical Research Center for Neurological Diseases, Dongcheng District, Beijing 100050, China.|Chinese Glioma Cooperative Group (CGCG), Dongcheng District, Beijing 100050, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Jiang
authors.affiliation: Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, NanGang District, Harbin, Heilongjiang Province 150001, China.|Chinese Glioma Cooperative Group (CGCG), Dongcheng District, Beijing 100050, China.
authors.forename: Chuanlu
authors.initials: C
authors.lastname: Jiang
keywords: ATRX; IDH-R132H; Ki-67; astrocytic tumors; progression