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WT1 expression distinguishes astrocytic tumor cells from normal and reactive astrocytes.

Abstract
Particularly in small brain biopsies, it might be difficult to distinguish reactive astrogliosis from low-grade or infiltration zones of high-grade astrocytomas. So far no immunohistochemical marker allows a reliable distinction. Recently, the over-expression of Wilms' tumor gene product WT1 was reported in astrocytic tumor cells. However, no sufficient data on WT1 expression in normal or reactive astrocytes are available. Therefore, we investigated WT1 expression in paraffin-embedded brain sections from 28 controls, 48 cases with astrogliosis of various etiology and 219 astrocytomas [World Health Organization (WHO) grades I-IV] by immunohistochemistry. In normal brains and in astrogliosis, expression of WT1 was restricted to endothelial cells. In astrocytomas, WT1-positive tumor cells were found in pilocytic astrocytomas (66.7% of cases), diffuse astrocytomas (52.7%) WHO grade II (52.7%), anaplastic astrocytomas (83.4%) and glioblastomas (98.1%). Overall, the majority of all astrocytic neoplasms (84.5%) expressed WT1. Establishing a cut-off value of 0% immunoreactive tumor cells served to recognize neoplastic astrocytes with 100% specificity and 68% sensitivity and was associated with positive and negative predictive values of 1 and 0.68, respectively. Therefore, WT1 expression in astrocytes indicates a neoplastic origin and might represent an important diagnostic tool to differentiate reactive from neoplastic astrocytes by immunohistochemistry.
AuthorsJens Schittenhelm, Michel Mittelbronn, Thai-Dung Nguyen, Richard Meyermann, Rudi Beschorner
JournalBrain pathology (Zurich, Switzerland) (Brain Pathol) Vol. 18 Issue 3 Pg. 344-53 (Jul 2008) ISSN: 1015-6305 [Print] Switzerland
PMID18371184 (Publication Type: Journal Article)
Chemical References
  • Biomarkers, Tumor
  • WT1 Proteins
Topics
  • Adult
  • Aged
  • Astrocytes (metabolism, pathology)
  • Astrocytoma (metabolism, pathology)
  • Biomarkers, Tumor (analysis)
  • Brain Neoplasms (metabolism, pathology)
  • Endothelial Cells (metabolism)
  • Female
  • Gene Expression
  • Gliosis (metabolism, pathology)
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • WT1 Proteins (biosynthesis)

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