Comparative analysis of adult and paediatric glioblastoma

Glioblastoma represents the most frequent and aggressive form of CNS cancers. This
tumour type is characterized by heterogeneity that makes the diagnosis, histological
classification and accurate therapy more difficult. Paediatric glioblastoma usually develops de
novo, however the genetic pathways leading to primary glioblastoma in adults is rarely involved
in children. Despite better understanding of genetics and biology of glioblastoma as a result of
recent progress in research, it remains incurable with five year survival rate less than 5% and
median survival of 12-15 months.
The aim of our study was to compare the molecular signature of paediatric and adult
glioblastoma. We retrospectively analyzed the medical records of 40 glioblastoma patients (21
males and 19 females) diagnosed at the University of Debrecen, Institute of Pathology between
2006 and 2015. According to the age at diagnosis, cases were further divided into three groups
(paediatric (0-18y; n=9); adults (19-55y; n=16 and elderly (>55y; n=15). Using formalin fixed,
paraffin embedded tissue sections, immunohistochemistry was carried out for ATRX, IDH1
and p53. Findings were correlated with gender, age, survival and anatomical localization of the
tumour. p53 histoscores marker was correlated with the ATRX and IDH1 status.
Our results demonstrate molecular differences between paediatric and adult
glioblastoma. These have therapeutic implications and suggest use of different treatment
protocols for paediatric and adult patients taking into account the molecular signatures. This
may improve survival in this devastating disease.
(This study was supported by the Hungarian Brain Research Program – Grants No.
KTIA_13_NAP-A-II/7 and KTIA_13_NAP-A-V/3.)