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Article

Aggressiveness of Grade 4 Gliomas of Adults

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Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
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Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
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Department of Neurology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
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Department of Radiology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
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Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, 900591 Constanta, Romania
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Academy of Medical Sciences of Romania, 030167 Bucharest, Romania
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Clinical Service of Pathology, Departments of Genetics, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
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Author to whom correspondence should be addressed.
Academic Editor: Anna Capasso
Clin. Pract. 2022, 12(5), 701-713; https://doi.org/10.3390/clinpract12050073
Received: 29 July 2022 / Revised: 24 August 2022 / Accepted: 1 September 2022 / Published: 3 September 2022
Grade 4 adult gliomas are IDH-mutant astrocytomas and IDH-wildtype glioblastomas. They have a very high mortality rate, with survival at 5 years not exceeding 5%. We aimed to conduct a clinical imaging and morphogenetic characterization of them, as well as to identify the main negative prognostic factors that give them such aggressiveness. We conducted a ten-year retrospective study. We followed the clinical, imaging, and morphogenetic aspects of the cases. We analyzed immunohistochemical markers (IDH1, Ki-67, and nestin) and FISH tests based on the CDKN2A gene. The obtained results were analyzed using SPSS Statistics with the appropriate parameters. The clinical aspects representing negative prognostic factors were represented by patients’ comorbidities: hypertension (HR = 1.776) and diabetes mellitus/hyperglycemia (HR = 2.159). The lesions were mostly supratentorial, and the temporal lobe was the most affected. The mean volume was 88.05 cm3 and produced a midline shift with an average of 8.52 mm. Subtotal surgical resection was a negative prognostic factor (HR = 1.877). The proliferative index did not influence survival rate, whereas CDKN2A gene mutations were shown to have a major impact on survival. We identified the main negative prognostic factors that support the aggressiveness of grade 4 gliomas: patient comorbidities, type of surgical resection, degree of cell differentiation, and CDKN2A gene mutations. View Full-Text
Keywords: astrocytoma; CDKN2A; glioblastoma; IDH1; Ki-67 astrocytoma; CDKN2A; glioblastoma; IDH1; Ki-67
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MDPI and ACS Style

Deacu, M.; Docu Axelerad, A.; Popescu, S.; Topliceanu, T.S.; Aschie, M.; Bosoteanu, M.; Cozaru, G.C.; Cretu, A.M.; Voda, R.I.; Orasanu, C.I. Aggressiveness of Grade 4 Gliomas of Adults. Clin. Pract. 2022, 12, 701-713. https://doi.org/10.3390/clinpract12050073

AMA Style

Deacu M, Docu Axelerad A, Popescu S, Topliceanu TS, Aschie M, Bosoteanu M, Cozaru GC, Cretu AM, Voda RI, Orasanu CI. Aggressiveness of Grade 4 Gliomas of Adults. Clinics and Practice. 2022; 12(5):701-713. https://doi.org/10.3390/clinpract12050073

Chicago/Turabian Style

Deacu, Mariana, Any Docu Axelerad, Steliana Popescu, Theodor Sebastian Topliceanu, Mariana Aschie, Madalina Bosoteanu, Georgeta Camelia Cozaru, Ana Maria Cretu, Raluca Ioana Voda, and Cristian Ionut Orasanu. 2022. "Aggressiveness of Grade 4 Gliomas of Adults" Clinics and Practice 12, no. 5: 701-713. https://doi.org/10.3390/clinpract12050073

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