Evaluation of Nestin and EGFR in patients with glioblastoma multiforme in Kashan Shahid Beheshti hospital from 2006-2017

Introduction: Glioblastoma multiforme (GBM) is a grade IV glioma according to the World Health Organization (WHO), accounts for 15% of all primary brain tumors and has a median survival range of less than 2 years after diagnosis.GBMs are histologically heterogeneous tumors derived from glial cells.. Neoangiogenesis is a crucial factor in malignant behavior and patients prognosis. . Several mechanisms are suspected to lead to neoangiogenesis; one of them is the recruitment of multipotent progenitor cells towards the tumor. It has recently been suggested that glioblastoma stem-like cells (GSCs) have the capacity to differentiate into functional endothelial cells; and some mutations as like as P53, EGFR and VEGF may play role. Nestin is a class VI intermediate protein that express in stem/ progenitor cells in CNS and endothelial cells of neoformed vessels in GBM. This study was designed to show the relation between EGFR mutation and microvascular density(MVD) . Nestin expression was used as MVD indicator.Material & Methods: We analyzed 40 GBM samples by immune histochemistry staining. The immunohistochemical expression of EGFR in tumoral cells and Nestin in endothelial cells in paraffin sections were analyzed: EGFR scoring was the based on staining intensity: Score 0( No staining), Score1(mild to moderate staining), score2(sever staining). Microvascular density(MVD) was evaluated with Nesin immunostaining .Results: The mean of MVD was 14.6 ±8.25. Nestin-MVD was significantly higher in GBM with sever vascular prolifration (P value=0.01).. EGFR was expressed in 92.5% of samples. The EGFR scoring for tumoral tissue was 7.5%(score:0), 22.5%(score:1) and 70%(score:2). There was a significant relationship between EGFR expression and MVD(P value=0.017).Conclusion: There was a positive relation between EGFR expression in GBM and vascular proliferation that was evaluated by Nestin expression. . Target terapy against EGFR pathway may be usefull for reduce tumor vasculogenesis and progression.

Evaluation of Nestin and EGFR in patients with glioblastoma multiforme in Kashan Shahid Beheshti hospital from 2006-2017 Keywords:

Glioblastoma Multiforme , Microvascular density. Nestin , EGFR , Angiogenesis