CD34 expression and clinical pathology characteristics of low-level brain tumors associated with epilepsy

Ref: Giulioni M,et alWorld Neurosurg2018 Sep 26doi: 10.1016/j.wneu.2018.09.212 (E expub of print)of epilepsy-related low-level brain tumors (low-grade epilepsy-associated tumors, LEATs) includes a large number of low-level gliomas or glioic neuronal tumorsTypical glioneuron neuronal tumors (GNTs), neuroconic glioglios, GGs, and embryonicly stunted neuroepilated tumors (dysembryoplastics, DNETs) are commonly found in the temporal lobe or adjacent temporal lobesThe mechanism of LEATs eclampsia is not clearCD34 is a marker used to evaluate LEATs, glial cell lesions, and stunted cellsCD34-positive cells are significantly present in lesions associated with refractory epilepsy, especially LEATsThe expression of CD34 can be seen in 80% of GGsAt present, cd34 has been identified as a valuable biological marker in the damage of glial cells associated with epilepsyThe MRI imaging characteristics of diffuse GNT were related to CD34 expressionHowever, there have been few studies on the clinical and pathological correlation of CD34 to epilepsy-related tumorsMarco Giulioni of the Institute of Neurosurgery at the University of Bologna, Italy, and others analyzed the relationship between CD34 expression and demographic data, clinical symptoms and pathological characteristics in patients with epilepsy surgery, and the results were published online in World Neurosurgery in September 2018researchers retrospectively included 187 LEATs patients treated at eight epilepsy surgery centers in Italy between January 2009 and June 2015Hetology diagnosis is based on the classification of central nervous system tumors of WHO Using single and multivariate analysis, the indicator variables related to CD34 expression are determined 111 (54.0%) of the 187 patients were male 105 (56.1%) were children aged 18 The median age of epilepsy was 9 years, with an average age of 11.7 years, the median age of surgery was 16 years, with an average age of 20.2 years, and the median duration of epilepsy was 4 years, with an average of 8.5 years 134 (71.7%) tumors were located in the temporal lobe and 53 (28.3%) in the outer temporal region The most common locations for tumors in the outer region were the frontal lobe (7.5%), followed by the top lobe (5.9%) and the pillow leaf (0.5%) In 27 cases (14.4%) the tumor sat grown in polyleafy 95 (50.8%) tumors were on the right and 92 (49.2%) on the left Between surgery, 36 cases (19.3%) had multiple seizures per day, 54 cases (28.9%) had seizures more than once per week, 60 cases (32.1%) had seizures more than once a month, and 10 (5.3%) patients had intermittent seizures, one or less per month In 27 cases (14.4%) the use of anti-epileptic drugs to control seizures Of the 137 patients who underwent preoperative neuropsychological evaluation, 51 (37.2%) had neuropsychological disorders 79 patients (42.2%) had a lesions to remove the tumor after determining the area associated with the seizure 108 cases (57.5%) were removed beyond the tumor range, including the surrounding eclampsia area 156 (83.4%) tumors were completely removed MrI was carried out early after surgery to determine the degree of tumor removal Nineteen cases (10.2%) showed surgical complications, of which 14 (7.5%) had neurological impairment, 7 (3.7%) were sensory disorders, 6 (3.2%) aphasia were aphasia and 1 (0.5%) had vision deficit histopathological examination found that 146 cases (78.1%) were gliotic neuronal hybrid tumors, 39 cases (20.9%) were gliomas and 2 (1.1%) were mixed neuroprecitity tumors All are WHOI or II levels 39 cases (20.9%) were diagnosed with tumor-related metacortical dysplasia (focal cortical dysplasia, FCD) In follow-up, 172 cases (92.0%) had a good prognosis (Engel I- no-loss epilepsy), 15 cases (8.0%) had poor prognosis, of which 11 (5.9%) were Enge1 III-Rare Deactivation Seizures, 3 (1.6%) were Engel III-Improved, and 1 (0.5%) were IV-No Improvement of 187 patients, 95 (50.8%) tested positive for CD34 Multi-factor analysis showed that tumor type and duration of epilepsy were independently associated with CD34 expression Compared with stunted neuroepitrospheric tumors, neuroconcell glioma and polymorphic progesterone astrocyte were the most associated tissue types with CD34-positive, with an advantage ratio of 9.2 and 10.4, respectively Compared to patients with epilepsy duration of less than 2 years, the expression of CD34 in patients with epilepsy duration of more than 10 years was significantly increased, and the probability of CD34 expression was 2.8 In addition, a single variable analysis showed that the expression of CD34 was significantly correlated with the increase in age at the time of surgery, the increase in the dose of anti-epileptic drugs (AEDs) and women finally the authors point out that CD34 expression is associated with factors such as the duration of clinical epilepsy and the type of tumor pathology Therefore, CD34 expression is expected to become a molecular biological marker in LEAT patients.