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 Volume 72, Number 2, January 13, 2009
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NEUROLOGY 2009;72:156-161
© 2009 American Academy of Neurology

{alpha}-Internexin expression identifies 1p19q codeleted gliomas

F. Ducray, MD, E. Crinière, MSc, A. Idbaih, MD, PhD, K. Mokhtari, MD, Y. Marie, MSc, S. Paris, MSc, S. Navarro, MD, F. Laigle-Donadey, MD, C. Dehais, MD, J. Thillet, PhD, K. Hoang-Xuan, MD, PhD, J. -Y. Delattre, MD and M. Sanson, MD, PhD

From Unité INSERM U711 (F.D., E.C., A.I., Y.M., S.P., J.T., K.H.-X., J.Y.-D., M.S.), Service de Neurologie Mazarin (F.D., A.I., F.L.-D., C.D., K.H.-X., J.Y.-D., M.S.), Laboratoire de Neuropathologie (K.M.), and Service de Neurochirurgie (S.N.), CHU Pitié-Salpêtrière, Université Paris VI, France.

Address correspondence and reprint requests to Dr. M. Sanson, Service de Neurologie Mazarin, Hôpital de la Salpêtrière, 47 Bd de l’Hôpital, 75013 Paris, France marc.sanson{at}psl.aphp.fr

Background: {alpha}-Internexin (INA) is a proneural gene encoding a neurofilament interacting protein that is upregulated in some gliomas, particularly oligodendrogliomas.

Methods: INA expression was evaluated by immunohistochemistry in a series of 122 gliomas, and correlated to the 1p19q codeletion, a favorable prognostic marker of oligodendroglial tumors.

Results: INA expression was strong (>10% positive cells) in 22 cases (22 oligodendroglial tumors and 0 astrocytic tumors), weak (<10% cells) in 14 cases (12 oligodendroglial tumors, 2 glioblastoma with an oligodendroglial component, and 0 astrocytic tumors), and negative in 86 cases (49 oligodendroglial tumors, 9 glioblastoma with an oligodendroglial component, and 28 astrocytic tumors). Among the 27 tumors exhibiting the 1p19q codeletion (all with an oligodendroglial phenotype), INA was detected in 96% (26/27, 18 strong, 8 weak) as compared to 11% (10/95, 4 strong, 6 weak) in the tumors without 1p19q codeletion (with an oligodendroglial or an astrocytic phenotype) (p < 0.001). In oligodendroglial tumors, INA expression specificity for 1p19q codeletion was 86%, sensitivity 96%, positive predictive value 76%, and negative predictive value was 98%. The prognostic impact of INA expression could be evaluated in grade III oligodendroglial tumors. Similar to 1p19q deletion, positive INA expression was correlated with better progression-free survival (52.6 vs 8.7 months [p = 0.001]) and overall survival (121.1 vs 31.4 months [p = 0.0001]).

Conclusion: {alpha}-Internexin (INA) expression appears to be a simple, reliable prognostic marker and a surrogate marker of 1p19q codeletion.

Abbreviations: CGH = comparative genomic hybridization array; FISH = fluorescent in situ hybridization; GBMO = glioblastoma with oligodendroglial component; HR = hazard ratio; INA = {alpha}-internexin; LOH = loss of heterozygosity; OS = overall survival; PFS = progression-free survival.

Supported by a grant of the Institut National du Cancer (INCA, PL046), the Délégation à la Recherche Clinique (MUL032), and by the Ligue Nationale contre le Cancer.

Disclosure: The authors report no disclosures.

Received June 19, 2008. Accepted in final form September 30, 2008.






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