Histological identification of dispersed glioma cells in small biopsies can be challenging, especially in tumours lacking the IDH1 R132H mutation or alterations in TP53. We postulated that immunohistochemical detection of proteins expressed preferentially in gliomas (EGFR, MEOX2, CD34) or during embryonal development (SOX11, INSM1) can be used to distinguish reactive gliosis from glioma. Tissue microarrays of 46 reactive glioses, 81 glioblastomas, 34 IDH1-mutant diffuse gliomas, and 23 gliomas of other types were analysed. Glial neoplasms were significantly more often (p < 0.001, χ2) positive for EGFR (34.1% vs. 0%), MEOX2 (49.3% vs. 2.3%), SOX11 (70.5% vs. 20.4%), and INSM1 (65.4% vs. 2.3%). In 94.3% (66/70) of the glioblastomas, the expression of at least two markers was observed, while no reactive gliosis showed coexpression of any of the proteins. Compared to IDH1-mutant tumours, glioblastomas showed significantly higher expression of EGFR, MEOX2, and CD34 and significantly lower positivity for SOX11. Non-diffuse gliomas were only rarely positive for any of the five markers tested. Our results indicate that immunohistochemical detection of EGFR, MEOX2, SOX11, and INSM1 can be useful for detection of glioblastoma cells in limited histological samples, especially when used in combination.

Department of Medical Biology and Genetics Charles University Faculty of Medicine in Hradec Králové Zborovská 2089 500 03 Hradec Kralove Czech Republic

Department of Neuroregeneration Institute of Experimental Medicine Czech Academy of Sciences 142 20 Prague Czech Republic

Department of Neurosurgery Charles University Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové Sokolska 581 500 05 Hradec Kralove Czech Republic

Department of Oncology and Radiotherapy Charles University Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové Sokolska 581 500 05 Hradec Kralove Czech Republic

Department of Pathology Military University Hospital Prague U Vojenske Nemocnice 1200 Praha 6 169 02 Prague Czech Republic

The Fingerland Department of Pathology Charles University Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové Sokolska 581 500 05 Hradec Kralove Czech Republic

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