Glioblastoma: o impacto das novas classificações no perfil da doença e de seu portador
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TCC
Data de publicação
2024-06-20
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Citações (Scopus)
Autores
Miake, Jéssica Megumi
Siqueira, João Pedro Schmidt de
Siqueira, João Pedro Schmidt de
Orientador
Sobral, Ana Cristina Lira
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Introdução: Glioblastomas são os tumores cerebrais originados na célula da glia. É a modalidade de tumor cerebral primário maligno mais comum e agressivo entre adultos, e apesar dos avanços relativos sobre a patologia, possui prognóstico limitado e baixa sobrevida. Ao que se sabe, sua incidência aumenta com idade avançada e em sexo masculino. O tratamento é baseado na ressecção cirúrgica máxima, radioterapia e quimioterapia. Na tentativa de padronizar o diagnóstico da doença, a Organização Mundial da Saúde (OMS) elaborou, em 1979, a classificação de tumores do sistema nervoso central (SNC). Periodicamente esta classificação é revista e atualizada, considerando a análise histopatológica e, mais recentemente, molecular das neoplasias. A análise de marcadores moleculares passou a ser utilizada a partir de 2016, com a implementação da avaliação do status do gene IDH1. Essa análise molecular foi refinada na classificação de 2021. Objetivo: Este trabalho tem como objetivo traçar o perfil do portador do glioblastoma (GBM), além de avaliar as características histopatológicas e imunohistoquímicas da doença diagnosticada de acordo com três diferentes classificações da OMS (2007, 2016 e 2021). Ademais, visa-se comparar os achados e estabelecer possíveis mudanças em decorrência da atualização destas classificações. Metodologia: Este estudo consistirá em uma análise retrospectiva de dados coletados em um banco de dados de um laboratório, em Curitiba, visando informações referentes a laudos anatomopatológicos e imunohistoquímicos de pacientes diagnosticados com glioblastoma em um período de 12 anos. Foram avaliados e, posteriormente, comparados os dados epidemiológicos, histológicos e o perfis biomoleculares dos laudos selecionados. Resultados: Foram recebidos e analisados 68 laudos anatomopatológicos e 59 laudos de imuno-histoquímica. Observou-se, nas três classificações, uma consistente predominância masculina entre os portadores de GBM, cuja idade média de início da doença situava-se entre 55 e 60 anos. Os lobos mais frequentemente acometidos pelo GBM foram o parietal e o temporal. Além disso, houve um aumento significativo no envolvimento do lobo frontal na classificação mais recente. Outras comparações, após análise estatística, não mostraram diferença significativa entre a classificações. Conclusão: Não foram identificadas diferenças significativas no perfil desses pacientes. No entanto, para uma compreensão mais aprofundada e para delimitar com maior precisão as nuances do progresso da classificação desta doença, são necessários estudos adicionais.
Introduction: Glioblastomas are brain tumors originating from glial cells. They represent the most common and aggressive form of primary malignant brain tumors in adults. Despite relative advancements in understanding the pathology, glioblastomas have a limited prognosis and a poor survival rate. Incidence tends to increase with advanced age and is more common in males. Treatment typically involves maximal surgical resection, followed by radiotherapy and chemotherapy. In an effort to standardize disease diagnosis, the World Health Organization (WHO) introduced the classification of central nervous system (CNS) tumors in 1979. This classification is periodically reviewed and updated, incorporating both histopathological and, more recently, molecular analyses of neoplasms. Molecular markers, including the evaluation of IDH1 gene status, have been utilized since 2016, with further refinements in the 2021 classification. Objective: This study aims to delineate the profile of glioblastoma (GBM) patients while evaluating the histopathological and immunohistochemical characteristics of the disease according to three different WHO classifications (2007, 2016, and 2021). Additionally, we seek to compare findings and identify potential changes resulting from the updates in these classifications. Methodology: The study involves a retrospective analysis of data collected from a laboratory database in Curitiba. We focus on anatomopathological and immunohistochemical reports from patients diagnosed with glioblastoma over a 12-year period. Epidemiological, histological, and biomolecular profiles from selected reports were evaluated and subsequently compared. Results: We analyzed 68 anatomopathological reports and 59 immunohistochemical reports. Across all three classifications, a consistent male predominance was observed among GBM patients, with an average disease onset age ranging from 55 to 60 years. The parietal and temporal lobes were most frequently affected by GBM. Notably, there was a significant increase in frontal lobe involvement in the most recent classification. After statistical analysis, other comparisons did not show a significant difference between the classifications. Conclusion: While no significant differences were identified in the patient profiles, further studies are necessary for a deeper understanding and precise delineation of nuances related to the evolving classification of this disease.
Introduction: Glioblastomas are brain tumors originating from glial cells. They represent the most common and aggressive form of primary malignant brain tumors in adults. Despite relative advancements in understanding the pathology, glioblastomas have a limited prognosis and a poor survival rate. Incidence tends to increase with advanced age and is more common in males. Treatment typically involves maximal surgical resection, followed by radiotherapy and chemotherapy. In an effort to standardize disease diagnosis, the World Health Organization (WHO) introduced the classification of central nervous system (CNS) tumors in 1979. This classification is periodically reviewed and updated, incorporating both histopathological and, more recently, molecular analyses of neoplasms. Molecular markers, including the evaluation of IDH1 gene status, have been utilized since 2016, with further refinements in the 2021 classification. Objective: This study aims to delineate the profile of glioblastoma (GBM) patients while evaluating the histopathological and immunohistochemical characteristics of the disease according to three different WHO classifications (2007, 2016, and 2021). Additionally, we seek to compare findings and identify potential changes resulting from the updates in these classifications. Methodology: The study involves a retrospective analysis of data collected from a laboratory database in Curitiba. We focus on anatomopathological and immunohistochemical reports from patients diagnosed with glioblastoma over a 12-year period. Epidemiological, histological, and biomolecular profiles from selected reports were evaluated and subsequently compared. Results: We analyzed 68 anatomopathological reports and 59 immunohistochemical reports. Across all three classifications, a consistent male predominance was observed among GBM patients, with an average disease onset age ranging from 55 to 60 years. The parietal and temporal lobes were most frequently affected by GBM. Notably, there was a significant increase in frontal lobe involvement in the most recent classification. After statistical analysis, other comparisons did not show a significant difference between the classifications. Conclusion: While no significant differences were identified in the patient profiles, further studies are necessary for a deeper understanding and precise delineation of nuances related to the evolving classification of this disease.
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Palavras-chave
neoplasias do sistema nervoso central , glioma , glioblastoma , organização mundial da saúde , epidemiologia , histologia comparada , imuno-histoquímica , biomarcadores tumorais , central nervous system neoplasms , glioma , glioblastoma , world health organization , epidemiology , comparative histology , immunohistochemistry , tumor biomarkers