الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Primary malignant brain tumors have the third highest cancer-associated mortality and morbidity rates among individuals worldwide. In Egypt, primary central nervous system (CNS) neoplasms are rare constituting about 1-2% of all human neoplasms with high grade gliomas are the most common type.
Gliomas can be classified as grade I to IV on the basis histological features and genetic alterations, as defined by the World Health Organization (WHO).
Three molecular markers were considered useful tools for the management of gliomas: 1p/19q chromosomal codeletion, O-6-methylguanine-DNA methyltransferase (MGMT) promoter methylation, and isocitrate dehydrogenase (IDH) 1 and 2 mutations. More than 70% of WHO grade II/III gliomas were found to harbor an IDH mutation.
Normal IDH catalyzes the NADP+ -dependent oxidative decarboxylation of isocitrate to α-ketoglutarate (α-KG), producing CO2 and NADPH in the process. It, therefore, plays an important role in biosynthesis of central metabolites in the tricarboxylic acid (TCA) cycle as well as in the generation of cellular NADPH.
IDH1 is particularly important in the brain as this is the main source of NADPH.
The present research specifically focused on evaluating the prognostic value of IDH1 in adult patients with brain gliomas. Patients that harbor an IDH1 mutation have a better response to treatment and a better progression free survival compared to those with IDH wild type gliomas as proved in our retrospective study on 30 adult patients with brain glioma.
All patients were adults, received definitive radiotherapy and followed at a minimum of 1 year, maximum of 5 years.
We used IHC technique to identify wild from mutant type IDH1 using the original dianova kit of mouse clone for IDH1 codon R 132.
What we found was that OS in IDH1 mutant gliomas (both high and low grades) was associated with better outcomes however results was statistically insignificant (which could be attributed to the low number of samples examined), while for PFS , it was associated with a statistically significant better outcomes for subjects harboring IDH1 mutation than those with an IDH1 wild-type
In summary, the present study provides further information regarding the role of IDH1 mutation in brain gliomas in Egyptian patients. IDH1 mutation is associated with better prognosis in all grades of gliomas, however, grades II & III brain gliomas were the most commonlly harboring the mutations, as well as showing a statistically significant better PFS