Prognostic significance of HIF1-alpha immunohistochemical expression in gliomas and it's relation to IDH1 mutation status

摘要

Background Gliomas are the commonest primary adults' brain tumors. Hypoxia performs an essential role in gliomas' initiation as well as progression through hypoxia inducible factor (HIF-1 alpha) activation, which could serve as a promising target in treatment of gliomas. Our study aimed to evaluate types and grades of glioma cases and detect isocitrate dehydrogenase 1 (IDH1) mutation status and expression of HIF-1 alpha in all included cases and its correlation with clinical data and pathological parameters.Results Samples from 71 patients who were diagnosed with glioma were studied immunohistochemically for IDH1-R132H (if indicated) and HIF-1 alpha expression. Expression of HIF-1 alpha was detected in 73.2 of the included 71 gliomas. HIF-1 alpha expression significantly increased in older patients, in high-grade gliomas and in tumors positive for necrosis. We studied IDH1 mutation in the histologically diagnosed grade 2, 3and 4 astrocytic and oligodendroglial tumors (51 cases out of the included 71 gliomas). IDH1-R132H immunohistochemical expression was positive in 62.7 of cases. IDH1 mutation was significantly higher with younger age. IDH1 mutation was noted also with lower tumor grade. A statistically significant relation was detected between negative IDH1-R132H expression and high level of HIF-1 alpha immunohistochemical expression.Conclusion Absence of IDH1 mutation with increased HIF-1 alpha expression among high-grade gliomas suggesting both as predicting indicators for poor prognosis.