Relationship Between Cytogenetic Complexity and Peritumoral Edema in High-Grade Astrocytoma

Abstract

Background: The purpose of the study is to reveal the association of cytogenetic compltyexi and peritumoral edema volume (PTEV) and its prognostic significance in high-grade astrocytoma patients by culturing patient tumor cells.

Methods: Twenty-seven high-grade astrocytoma patients were divided into three groups according to karyotype complexity: normal, non-complex karyotype (NCK), and complex karyotype (CK). Endothelial growth factor receptor (EGFR) amplification was detected by FISH, and its association with chromosome 7 abnormalities was analyzed. Mean PTEV of each group was compared by ANOVA to evaluate the relationship between PTEV and cytogenetic complexity.

Results: The PTEV of patients in normal (n=6), NCK (n=8), and CK (n=13) groups were 24.52±17.73, 34.26±35.04, and 86.31±48.7 cm³, respectively (P=0.005). Ten out of 11 patients with EGFR amplification showed abnormalities in chromosome 7. The mean PTEV of EGFR-amplified and non-amplified groups were 80.4±53.7 and 41.3±37.9 cm³, respectively (P=0.035). The average survival of patients with PTEV less than 90 cm³ was 30.52±26.11 months, while in patients with PTEVs over or equal to 90 cm³, it was 10.83±5.53 months (P=0.007).

Conclusions: The results show an association of complex karyotype with the PTEV of high-grade astrocytoma. EGFR amplification plays a significant role in the formation of peritumoral edema, causing PTEV to increase, which is related with survival. This implies that cytogenetic karyotype can be applied as a prognostic factor.

Keywords: Chromosome; EGFR amplification; High-grade astrocytoma; Peritumoral edema.

Fig. 1. Kaplan-Meier Survival curve of patients with peritumoral edemas less than 90 cm³ and patients with peritumoral edema of 90 cm³ or greater, as analyzed by the log-rank test.

Fig. 2. T2 FLAIR image (A) and T1 gadolinium-enhanced magnetic resonance imaging (MRI) image (B) of a 55-yr-old anaplastic astrocytoma patient with a normal female chromosome (C) and without EGFR amplification. There is minimal high signal around the tumor mass. The survival of the patient was 110 months.

Fig. 3. T1 gadolinium-enhanced magnetic resonance imaging (MRI) image (A) and T2 FLAIR image (B) of a 66-yr-old glioblastoma multiforme patient with complex karyotype (C) and positive EGFR amplification. A large amount of peritumoral edema with a midline shift was confirmed by T2 FLAIR image. 50,XY, dic(1;4)(p1 3;q35),+5,+7,+7,add(6p),del(7)(p15),add(9)(p24),add(17)(q25) add(19)(q13.4), add(21)(p13),+mar[20]. The survival of the patient was 9 months.