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Title: Primary and Secondary Glioblastoma in Kuwait
Authors: Sarah Talib Hussain 
Supervisor: Dr. Anwar Al-Banaw
Keywords: Primary and Secondary Glioblastoma in Kuwait
Issue Date: 2018
Publisher:  Kuwait university - college of graduate studies
Abstract: This study has been necessitated by paucity of information on molecular biomarkers and clinical characteristics of glioblastoma (GBM) in Kuwait. The purpose of this study was to document the molecular biomarkers of adult GBM in Kuwait using isocitrate dehydrogenase 1 (IDH1), p53 and epidermal growth factor receptor (EGFR). We also aimed to determine the effect of the population structure in the epidemiology of secondary GBM and suggest guidelines for selection of cases for IDH1 DNA sequencing. One hundred adult cases (≥20 years old) with initial histological diagnosis of GBM made in Al-Sabah Hospital between 2009 and 2016 were identified from the Pathology records. The blocks were collected partly for immunohistochemistry (IHC) and partly for DNA sequencing. Patients’ characteristics and relevant clinical data were retrieved from the records of both Ibn Sina Hospital and Kuwait Cancer Control Centre. IDH1 mutation was found in 10% of the cases with a mean age of 40.9 years and were <60 years old. These cases were classified as secondary GBM. The remaining 90% were primary GBMs with a mean age of 50.7 years. No mutation was detected in all 16 IHC mutant IDH1 negative cases subjected to DNA sequencing. Furthermore, the expression of EGFR was seen in all age groups and a significant association was found between p53 expression and secondary GBM. About 23% of primary GBM and 60% of secondary GBM had p53+/EGFR- phenotype. EGFR+/p53- expression was exclusive for primary GBM. EGFR+/ p53+ and EGFR-/ p53- phenotypes were noted in 11% and 39% of GBM respectively; these were predominantly primary GBM. Secondary GBM had single lesions while multiple lesions occurred only in primary GBM. Secondary GBM lesions had a lobar distribution with predominance (60%) of frontal lobe, none occurred in the occipital lobe. Primary GBM had a widespread distribution and involved all lobes, splenium, thalamus and cerebellum. We concluded that despite the young population structure of Kuwait, the proportion of secondary GBM was equivalent to other populations with an elderly structure. We also found that multiple lesions and EGFR+/p53- phenotype are exclusive features of p-GBM. Finally, sequencing should only be performed on IHC negative cases for mutant IDH1 if the patient has a single lesion, is below the age of 60 years and has duration of symptoms ≥3 months or concurrent negative wild type IDH1 IHC
Appears in Programs:0712 Medical Laboratory Sciences

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