Correspondence regarding: diagnostic utility of IDH1/2 mutation analysis in routine clinical testing of formalin-fixed paraffin-embedded glioma tissues. J Neuropathol Exp Neurol 2009:68;1319-25.

摘要

I read the recent report in the journal by Horbinski et al with great interest (1). The authors concluded that, "These results indicate that testing for IDH1/2 mutations can be effectively performed in a clinical setting and can enhance the accuracy of diagnosis of gliomas when traditional diagnostic methods are not definitive" (1). There is no doubt that the proposed method is useful in diagnosis, but for routine clinical use, I have the following concerns. First, the cost-effectiveness of this new approach versus the classical approach should be demonstrated. Second, the major question is whether the new technique is a time-consuming and easy-to-use procedure in clinical practice. Third, it should be noted that not all gliomas possess IDH1/2 mutations (2); other kinds of brain rumors can also possess IDH imitations (3). The false-positive, false-negative and predictive values of the new test need further verification.