The clinical and pathological features of low-grade epilepsy-associated glioneuronal tumors

The aim of the study was to evaluate the clinicopathological features, as well as the surgical prognosis, of epilepsy-associated glioneuronal tumors (GNT) with CD34 expression and BRAF mutation. Clinical data of patients who underwent epilepsy surgery for GNT were retrospectively studied. Univariate and multivariate analyses were performed to evaluate the correlations of clinical and pathological factors with molecular markers of CD34 expression and BRAF(V600E) mutation in GNT. A total of 247 patients with GNT had immunohistochemical detection of CD34 expression (CD34 positive vs. negative: 198/49), and among them, 102 patients had immunohistochemical detection of BRAF(V600E) mutation (BRAF positive vs. negative: 59/43). Univariate analysis found that tumor types (P < 0.001), patient population (P = 0.015), seizure aura (P = 0.007), drug-resistant epilepsy (P = 0.036), concordance of ictal electroencephalogram (EEG) findings (P = 0.032), surgical resection extent (P = 0.045), tumor location (P = 0.007) and duration of epilepsy (P = 0.027) were related to CD34 expression, and that concordance of ictal EEG findings (P = 0.031) and age at surgery (P = 0.015) were related to BRAF(V600E) mutation. In addition, history of generalized tonic-clonic seizure (HR 0.12; P = 0.035), drug-resistant epilepsy (HR 0.13; P = 0.030) and concordance of interictal EEG findings (HR 8.01; P = 0.039) were associated with tumor progression-free survival (PFS). However, CD34 expression or BRAF(V600E) mutation in GNT was not associated with surgical outcomes of seizure control and tumor PFS. The CD34 expression or BRAF(V600E) mutation in GNT may partly influence the distribution of clinicopathological features of patients with epilepsy, but they may be not able to predict the surgical prognosis of seizure outcome and tumor recurrence.