IMMUNOHISTOCHEMICAL EXPRESSION OF NESTIN – A NEURAL STEM/PROGENITOR CELL MARKER IN GLIAL TUMORS

Dr. Sunita Singh, Dr. Vikas, Dr. Yashika Bhatia*, Dr. Ishwar Singh, and Dr. Rajeev Sen

ABSTRACT

Objective: Glial tumors as a group constitute one of the important tumors of brain both in India and in the world. The present study was done with the aim to study immunohistochemical expression of nestin in glial tumors and to evaluate expression of nestin in different grades of Gliomas according to WHO grading. Material and Methods: A total of 40 cases of glial tumors were included in the study. Glial tumors were graded histomorphologically as Pilocytic astrocytoma, Fibrillar Astrocytoma (Grade-II), Anaplastic Astrocytoma (Grade-III), Glioblastoma, Oligodendroglioma (Grade-III) and Oligoastrocytoma (Grade-II). Nestin expression was assessed and correlated with histopathological grade (WHO classification) of glial tumors. Furthermore, immunochemistry for GFAP, S-100 and VEGF was applied and correlation between nestin expression and GFAP, S-100 and VEGF was studied. Results: Out of 40 cases, most of the cases were Glioblastoma Multiforme; WHO grade IV(42.5%) followed by astrocytoma; WHO grade II (22.5%) and anaplastic astrocytoma; who grade III(12.5%). Nestin expression was assessed and correlated with histopathological grade (WHO classification) of glial tumors. Nestin immunoexpression was present in 35 cases (89.5%) out of 40 cases. Out of 40 cases of glial tumors, GBM constitute 17 cases. Out of which 16 cases showed maximum nestin grading (3+). In lower grade gliomas (WHO grade I & II) immunoexpression of nestin was weak. Statistically significant correlation was noted in the immunoexpression of VEGF and Nestin, (p value 0.008). Conclusion: There is increase in immunoexpression of nestin with increase in grade of malignancy from WHO grade I to IV. Nestin expression may be a potential indicator of biological aggressiveness of the tumors and may be considered as marker of tumor burden and recurrence in human gliomas.

Keywords: glial tumors, astrocytoma, oligodendroglioma and nestin.