CD34 neural progenitor cells in glioblastoma multiforme

Background and Aim: Glioblastoma multiforme (GBM) is a World Health Organization (WHO) Grade IV malignant tumor with astrocytic differentiation. Despite medical advances over the past few decades, the life expectancy of patients with GBM has remained relatively unchanged 8–12 months. There are two proposed mechanisms for the development of GBM – a natural progression of lower WHO-grade astrocytoma and de novo development. Both theories, however, center on neural progenitor cells in the central nervous system. The aim of this study was to evaluate the significance of CD34 neural stem cell progenitors in GBM. Materials and Methods: Fourteen cases (eight males and seven females, age 16–74 years) of tumors with astrocytic differentiation were evaluated using the automated immunohistochemistry detection algorithm of Qupath v0.2.0-m4. Due to CD34 marking not only neural progenitors but also endothelial cells, the tumors were evaluated over an area of 76 mm[2], with blood vessels excluded from the analysis. In superficial tumors, again, an area of 76 mm[2] was evaluated in the subpial one. This study was approved by the Committee on Ethics for Scientific Research, Medical University – Varna “Prof. Dr. Paraskev Stoyanov” (protocol no. 20[1]) on April 26, 2012. Results: The tumors included 11 GBMs, 2 gliosarcomas, and 1 WHO Grade II astrocytoma. Only the GBMs were subjected to statistical analysis due to the small sample size. Both the hotspot (P = 0.076) and subpial (P = 0.243) values did not show a correlation with patients' survival, with borderline expression being defined as >3.6% (high) and <3.6% (low). Conclusion: Despite the specific patterns of growth and diffuse spread of CD34+ progenitors, their percentage does not correlate with patients' survival.