PT  - JOURNAL ARTICLE
AU  - Cai, Hong-Qing
AU  - Wang, Peng-Fei
AU  - Zhang, Hai-Peng
AU  - Cheng, Zhi-Jian
AU  - Li, Shou-Wei
AU  - He, Jie
AU  - Zhang, Yu
AU  - Hao, Jia-Jie
AU  - Wang, Ming-Rong
AU  - Yan, Chang-Xiang
AU  - Wan, Jing-Hai
TI  - Phosphorylated Hsp27 is mutually exclusive with ATRX loss and the IDH1<sup>R132H</sup> mutation and may predict better prognosis among glioblastomas without the IDH1 mutation and ATRX loss
AID  - 10.1136/jclinpath-2018-205000
DP  - 2018 Aug 01
TA  - Journal of Clinical Pathology
PG  - 702--707
VI  - 71
IP  - 8
4099  - http://jcp.bmj.com/content/71/8/702.short
4100  - http://jcp.bmj.com/content/71/8/702.full
SO  - J Clin Pathol2018 Aug 01; 71
AB  - Aim To identify biomarkers for accurate classification of glioma.Patients and methods We evaluated the heat shock protein 27 (Hsp27), phosphorylated Hsp27 (p-Hsp27), ATRX and IDH1R132Hproteins using immunohistochemistry in 421 glioma tissues. The χ2 test was used to assess the relationship between molecular alterations and clinico-pathological parameters. Kaplan-Meier survival curves were constructed, and differences were detected by the log-rank test.Results We found that Hsp27 and p-Hsp27 were mainly expressed in aggressive astrocytic gliomas. However, neither Hsp27 nor p-Hsp27 expression was related to survival time for any grade of glioma. Interestingly, p-Hsp27 was mutually exclusive with ATRX loss (ATRX−) and the IDH1R132H mutation, except for one case of anaplastic astrocytoma. We classified glioblastomas (GBMs) into three subtypes: ATRX−/IDH1R132H, high p-Hsp27 expression (p-Hsp27+) and none of these three markers. ATRX-/IDH1R132Hshowed the longest median survival (19.6 months). The prognostic difference between p-Hsp27+ and none of these three markers was significant (15.0 vs 13.1 months, P=0.045). Moreover, p-Hsp27+ predicted better sensitivity for standard therapy among GBMs without the IDH1 mutation and ATRX loss (26.3 vs 15.5 months, P=0.008).Conclusion p-Hsp27 is a novel biomarker of glioma and might have important clinical value for further classification of patients with wild-type IDH1 and normal ATRX expression, for evaluating prognosis and for guidance for adjuvant therapy.