Earlier this month the 102nd Annual Meeting of the United States and Canadian Academy of Pathology was held in Baltimore, Maryland. Frankly, this isn't a meeting that I have ever followed because I don't remember a pediatric brain tumors presence previously-- and certainly not the unresectable, rarely biopsied diffuse intrinsic pontine glioma. This just isn't something that pathologist do. Yet, on a Wednesday afternoon, a DIPG poster- Histology and Immunohistochemical Profile of Diffuse Intrinsic Pontine Gioma- took its place among a myriad of other neuropathology presentations.
This joint NIH/Hopkins abstract presented the characteristics of of 24 DIPGs autopsy specimens. Histologic results are as follows:
17- GBM with 14/17 having pseudopallisading necrosis and 12/17 with vascular proliferation
5- anaplastic astrocytoma
1- low grade (WHO II)
1- intermediate (features of WHO II and III)
Immunohistochemical results revealed all were GFAP positive. Regarding the stem cell markers, 22/24 were Oligo2 positive and 19/24 were Sox2 positive. In addition, 20/24 16/24 were positive for p53 and EGFR respectively.
What does all this mean? Well, all of these were gliomas. The high level of stem cell markers would seem to support the hypothesis of a tumor stem cell origin for DIPG. Understanding the pathways that have gone awry with DIPG we might be able to better identify prognostic markers and potential therapeutic targets.
It also means that DIPG research has began to make strides in tumor biology. In the future, people that really want to understand DIPG research will have to gain an understanding in pathways and cancer stem cells. Excellent chapters by Mark Kieran and Michelle Monje are in the ACCO book Understanding the Journey.
Additionally, it means that 24 parents selflessly gave an ultimate gife in the fight against DIPG-without which I don't see any possible way we could get to a cure. There is no doubt we could not have gotten to this research. It is with deep gratitude that I recognized these families that endured the unimaginable and jumped over logistical hurdles to make a difference.
Note- Interestingly Oligo2 importance with PDFRA was just mentioned on Friday here with the UCSF research.
Reference-
Abstract- http://www.abstracts2view.com/uscap13/view.php?nu=USCAP13L_1726
UCSF Research- http://dipg.blogspot.com/2013/03/focus-on-research-hashizume-laboratory.htm
ACCO DIPG Book-
http://myemail.constantcontact.com/New-FREE-resource-for-DIPG-Families-.html?soid=1102946333954&aid=k63YiippnW8
