|Table of Contents|

Value of intraoperative frozen section combined with rapid immunohistochemistry in the diagnosis of central nervous system lymphoma and high-grade glioma

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 20
Page:
3864-3867
Research Field:
Publishing date:

Info

Title:
Value of intraoperative frozen section combined with rapid immunohistochemistry in the diagnosis of central nervous system lymphoma and high-grade glioma
Author(s):
SUN Huan; WANG Zhiming; XIA Wei; LIU Jinqiu; LYU Haijun; DAI Xiaoxiao
Department of Pathology,the Second Affiliated Hospital of Soochow University,Jiangsu Suzhou 215000，China.
Keywords:
RD-IHC; CNSL; high-grade gliomas
PACS:
R739.4
DOI:
10.3969/j.issn.1672-4992.2024.20.008
Abstract:
Objective:To investigate the feasibility and significance of intraoperative frozen section combined with rapid immunohistochemistry(RD-IHC) in the diagnosis of central nervous system lymphomas (CNSL) and high-grade gliomas(HGG).Methods:A total of 18 cases of CNSL and 24 cases of high-grade gliomas from January 2019 to December 2023 in our hospital were collected.Intraoperative frozen sections with hematoxylin and eosin (HE) staining and RD-IHC were used to detect the leukocyte common antigen (LCA) and glial fibrillary acidic protein (GFAP) expression in the two diseases.Immunohistochemistry results of paraffin sections were used as the gold standard to compare the accuracy of diagnosing CNSL and high-grade gliomas using intraoperative frozen sections with HE staining and RD-IHC.Results:The accuracy of diagnosis using intraoperative frozen section RD-IHC and HE staining for CNSL was 100.00% and 72.22%,respectively,with a statistically significant difference（P=0.045）.The expression rates of LCA positivity and GFAP negativity in CNSL were significantly higher than those in high-grade gliomas using intraoperative frozen section RD-IHC （P＜0.001）.Conclusion:Intraoperative frozen section RD-IHC is superior to HE staining for the diagnosis of CNSL and high-grade gliomas.The combination of LCA and GFAP can serve as rapid immunohistochemical markers for distinguishing CNSL from high-grade gliomas on intraoperative frozen sections.

References:

［1］ YANG P,YANG L,DONG YM.Impact of intraoperative frozen section pathology on the treatment outcome of unilateral papillary thyroid microcarcinoma and its influencing factors-a retrospective cohort study［J］.Gland Surg,2022,11(10):1656-1664.
［2］ 高少阳,王明伟,张盛,等.建立优化的术中快速免疫组化检测体系［J］.临床与实验病理学杂志,2021,37(1):108-109. GAO SY,WANG MW,ZHANG S,et al.Establishment of an optimized intraoperative rapid immunohistochemical detection system［J］.Chinese Journal of Clinical and Experimental Pathology,2021,37(1):108-109.
［3］ LOUIS DN,PERRY A,WESSELING P,et al.The 2021 WHO Classification of Tumors of the Central Nervous System:a summary ［J］.Neuro Oncol,2021,23(8):1231-1251.
［4］ LIU M,ZHAO SQ,YANG L,et al.A direct immunohistochemistry (IHC) method improves the intraoperative diagnosis of breast papillary lesions including breast cancer ［J］.Discov Med,2019,28(151):29-37.
［5］ ABOUSHOUSHA T,MAMDOUH S,HAMDY H,et al.Immunohistochemical and biochemical expression patterns of TTF-1,RAGE,GLUT-1 and SOX2 in HCV-associated hepatocellular carcinomas ［J］.Asian Pac J Cancer Prev,2018,19(1):219-227.
［6］ 刘梅,李席如,宋欣,等.术中快速直接免疫组化在乳腺病变和前哨淋巴结诊断中的应用［J］.诊断病理学杂志,2018,25(03):170-176. LIU M,LI XR,SONG X,et al.Rapid immunohistochemistry in the diagnosis of breast lesions and sentinel lymph nodes［J］.Chinese Journal of Diagnostic Pathology,2018,25(03):170-176.
［7］ ZHANG XB,LIU JY,YAN XL.Rapid intraoperative immunocytochemistry of central nervous system tumors［J］.Int J Clin Exp Pathol，2020,13(1):44-48.
［8］ CHAGANTI J,TAYLOR M,WOODFORD H,et al.Differentiation of primary central nervous system lymphoma and high-grade glioma with dynamic susceptibility contrast-derived metrics:Pilot study［J］.World Neurosurg,2021,151:e979-e987.
［9］ OSTROM QT,GITTLEMAN H,LIAO P,et al.CBTRUS statistical report:Primary brain and other central nervous system tumors diagnosed in the United States in 2010-2014［J］.Neuro Oncol,2017,19(suppl_5):v1-v88.
［10］ KONING ME,HOF JJ,JANSEN C，et al.Primary central nervous system lymphoma ［J］.J Neuro,2024,271(5):2906-2913.
［11］ ZHU T,XIE P,GAO YF,et al.Nucleolar and spindle-associated protein 1 is a tumor grade correlated prognosis marker for glioma patients ［J］.CNS Neurosci Ther,2018,24(3):178-186.
［12］ GAO LM,ZHANG MC,ZHANG Y,et al.Progress of radiological pathological workflows in the differential diagnosis between primary central nervous system lymphoma and high grade glioma (review)［J］.Oncol Rep,2023,49(1):20.
［13］ LI J,WANG Y,MENG X,et al.Modulation of transcriptional activity in brain lower grade glioma by alternative splicing ［J］.PeerJ,2018,6:e4686.
［14］ STITZLEIN LM,ADAMS JT,STITZLEIN EN,et al.Current and future therapeutic strategies for high-grade gliomas leveraging the interplay between epigenetic regulators and kinase signaling networks ［J］.J Exp Clin Cancer Res,2024,43(1):12.
［15］ 王沛沛,李金凯,李彩虹,等.脑胶质瘤放疗计划设计的探索和评价［J］.现代肿瘤医学，2023,31(18):3442-3446. WANG PP,LI JK,LI CH,et al.Exploration and evaluation of the radiotherapy plan for glioma［J］.Modern Oncology,2023,31(18):3442-3446.
［16］ SHARMA K,SINGH J,FROST EE,et al.MeCP2 overexpression inhibits proliferation,migration and invasion of C6 glioma by modulating ERK signaling and gene expression ［J］.Neurosci Lett,2018,674:42-48.
［17］ PINCHI E,FRATI A,CIPOLLONI L,et al.Clinical-pathological study on β-APP,IL-1β,GFAP,NFL,Spectrin II,8OHdG,TUNEL,miR-21,miR-16,miR-92 expressions to verify DAI-diagnosis,grade and prognosis ［J］.Sci Rep,2018,8(1):2387.
［18］ 虞飞,冯立文,项鹏程,等.不同抗原修复方法在淋巴瘤免疫组化检测中的应用［J］.诊断病理学杂志,2019,26(9):622-623. YU F,FENG LW,XIANG PC,et al.Application of different antigen repair methods in immunohistochemical detection of lymphoma［J］.Chinese Journal of Diagnostic Pathology,2019,26(9):622-623.

Memo

Memo:
省部共建放射医学与辐射防护国家重点实验室开放课题（编号：GZK12023019）
Last Update: 1900-01-01