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Juvenile pilocytic astrocytomas: A search for prognostic markers

Introduction: Juvenile pilocytic astrocytomas are one of the most frequent central nervous system tumours occurring in children. While they are classified as WHO Grade I tumours, their natural progression is difficult to predict with some patients suffering significant morbidity and mortality despit...

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Main Author: Osman, Naeem
Other Authors: Pillay, Komala
Format: Thesis
Language:English
Published: Department of Pathology 2023
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access_status_str Open Access
author Osman, Naeem
author2 Pillay, Komala
author_browse Osman, Naeem
Pillay, Komala
author_facet Pillay, Komala
Osman, Naeem
author_sort Osman, Naeem
collection Thesis
description Introduction: Juvenile pilocytic astrocytomas are one of the most frequent central nervous system tumours occurring in children. While they are classified as WHO Grade I tumours, their natural progression is difficult to predict with some patients suffering significant morbidity and mortality despite showing similar light microscopic features. Activation of the MAPK pathway of cell proliferation is a consistent finding in these tumours. Studies of these tumours are largely aimed at components of this pathway in an effort to establish reliable prognostic and predictive markers. Aims and objectives: Our study was aimed at reviewing the light microscopic features and also evaluating the BRAF, p16 and protein kinase ERK components of the MAPK pathway. The findings thereof were correlated with the clinical picture to establish if these markers have any prognostic or predictive value. Materials and methods: The total number of cases retrieved was 62. The light microscopic findings were evaluated. The cases were analysed for overexpression of BRAF by fluorescence in-situ hybridisation and p16 and pERK by immunohistochemistry. Our findings were considered statistically significant if P < 0.05. Results: There were no specific light microscopic findings present in those cases associated with disease progression and recurrence. BRAF overexpression was associated with better clinical outcomes (P=0.03). There was no statistically significant correlation between p16 and pERK expression and patient outcomes. Conclusion: Overexpression of BRAF in juvenile pilocytic astrocytomas is associated with better clinical outcomes. BRAF may still serve as a therapeutic target and reduce risks associated with surgery, especially in tumours that are not surgically accessible. Further evaluation of p16, pERK and other components of the MAPK pathway of cellular proliferation will undoubtedly be useful in identifying therapeutic targets for those patients who experience disease recurrence and progression.
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language eng
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2023
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spelling oai:open.uct.ac.za:11427/37724 Juvenile pilocytic astrocytomas: A search for prognostic markers Osman, Naeem Pillay, Komala Anatomical Pathology Introduction: Juvenile pilocytic astrocytomas are one of the most frequent central nervous system tumours occurring in children. While they are classified as WHO Grade I tumours, their natural progression is difficult to predict with some patients suffering significant morbidity and mortality despite showing similar light microscopic features. Activation of the MAPK pathway of cell proliferation is a consistent finding in these tumours. Studies of these tumours are largely aimed at components of this pathway in an effort to establish reliable prognostic and predictive markers. Aims and objectives: Our study was aimed at reviewing the light microscopic features and also evaluating the BRAF, p16 and protein kinase ERK components of the MAPK pathway. The findings thereof were correlated with the clinical picture to establish if these markers have any prognostic or predictive value. Materials and methods: The total number of cases retrieved was 62. The light microscopic findings were evaluated. The cases were analysed for overexpression of BRAF by fluorescence in-situ hybridisation and p16 and pERK by immunohistochemistry. Our findings were considered statistically significant if P < 0.05. Results: There were no specific light microscopic findings present in those cases associated with disease progression and recurrence. BRAF overexpression was associated with better clinical outcomes (P=0.03). There was no statistically significant correlation between p16 and pERK expression and patient outcomes. Conclusion: Overexpression of BRAF in juvenile pilocytic astrocytomas is associated with better clinical outcomes. BRAF may still serve as a therapeutic target and reduce risks associated with surgery, especially in tumours that are not surgically accessible. Further evaluation of p16, pERK and other components of the MAPK pathway of cellular proliferation will undoubtedly be useful in identifying therapeutic targets for those patients who experience disease recurrence and progression. 2023-04-14T08:17:06Z 2023-04-14T08:17:06Z 2022 2023-04-14T06:44:40Z Master Thesis Masters MMed http://hdl.handle.net/11427/37724 eng application/pdf Department of Pathology Faculty of Health Sciences
spellingShingle Anatomical Pathology
Osman, Naeem
Juvenile pilocytic astrocytomas: A search for prognostic markers
thesis_degree_str Master's
title Juvenile pilocytic astrocytomas: A search for prognostic markers
title_full Juvenile pilocytic astrocytomas: A search for prognostic markers
title_fullStr Juvenile pilocytic astrocytomas: A search for prognostic markers
title_full_unstemmed Juvenile pilocytic astrocytomas: A search for prognostic markers
title_short Juvenile pilocytic astrocytomas: A search for prognostic markers
title_sort juvenile pilocytic astrocytomas a search for prognostic markers
topic Anatomical Pathology
url http://hdl.handle.net/11427/37724
work_keys_str_mv AT osmannaeem juvenilepilocyticastrocytomasasearchforprognosticmarkers