From the morphological to the integrated diagnosis of diffuse gliomas – a retrospective study

by Dominik Adl Amini
Doctoral thesis
Date of Examination:2023-09-21
Date of issue:2023-08-03
Advisor:Prof. Dr. Wolfgang Brück
Referee:Prof. Dr. Wolfgang Brück
Referee:Prof. Dr. Dorothee Mielke
Persistent Address: http://dx.doi.org/10.53846/goediss-10033

 

 

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Abstract

English

From the first classification of brain tumors by Rudolf Virchow in 1863 to our most recent WHO 2016 Classification, more than 150 years have passed. Within that time period, our understanding and scientific progress has increased exponentially, not just with brain tumors but with tumors and medicine in general. With rapidly enhancing technologies and research findings, such as molecular data and genetic alterations in gliomas, this trend will continue and the gap between major evolutions will shrink more and more. The goal of this project was to retrospectively analyze non-glioblastoma glial neoplasms following the most recent guidelines (WHO 2016 Classification) and to compare the reclassification with the original diagnoses made by using the WHO 2007 Classification. To be more precise, comparison between the diagnoses made with the WHO 2007 to the newest WHO 2016 Classification should be carried out while focussing on what amount of diagnoses might change or if even changes can be demonstrated. Moreover, if changes in the diagnosis are present, we want to ascertain the cause of change. Furthermore, potential immunohistochemical markers should be assessed which might help the observer to more precisely diagnose patients with the right tumor. The results showed that nearly one third (32.0%) of all diagnoses made with the previous 2007 Classification changed while using the most recent WHO 2016 standards of classifying low grade gliomas. Furthermore, we could display the major cause of change for the diagnosis, which is the lack of 1p19q codeletion. More precisely, 40.0% of the cases changed from previous oligodendrogliomas to now astrocytomas (lack of 1p19q codeletion) whilst only 4.3% of all cases showed reverse changes of entity from previously astrocytomas to now oligodendrogliomas (present 1p19q codeletion).
Keywords: diffuse gliomas; Haarlem Consensus; 2016 WHO Classification; astrocytoma; oligodendroglioma
 
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