Molecular biological features of cyst wall of adamantinomatous craniopharyngioma

The molecular biological differences between cyst walls and those in solid bodies are the foundation of the outcomes. In this study, the CTNNB1 mutations were confirmed by DNAsequencing; CTNNB1 expression levels were detected by PCR; the differences between solid bodies and cyst walls in proliferative capacity and tumor stem cell niches were assessed by immunohistochemistry; the effect of the residual cyst wall on recurrence was assessed by follow-up. Mutations in the CTNNB1 in the cyst wall and the solid body were identical in each case. No differences were found in the transcriptional level of CTNNB1 between the cyst walls and the solid bodies (P = 0.7619). The cyst wall showed a pathological structure similar to the solid body. Proliferative capacity of cyst walls was stronger than that of solid body (P = 0.0021), and beta-catenin nuclear positive cells (cell clusters) in cyst walls were more than that in solid tumor (P = 0.0002). The retrospective 45 ACPs showed residual cyst wall was significantly associated with tumor recurrence or regrowth (P = 0.0176). Kaplan-Meier analysis showed there was a significant difference in the prognosis between GTR and STR (P < 0.0001).The cyst wall of ACP contained more tumor stem cell niches which could lead to the recurrence. According to the above-mentioned, a special attention to the management of the cyst wall should be paid.

Automated summary

This study confirmed CTNNB1 mutations and detected CTNNB1 expression levels in cyst walls and solid bodies. The proliferative capacity and tumor stem cell niches were assessed to compare the differences between cyst walls and solid bodies. The effect of residual cyst wall on recurrence was also evaluated. The results showed that CTNNB1 mutations were identical in cyst walls and solid bodies, and there was no significant difference in CTNNB1 transcriptional levels between them. The cyst wall exhibited a stronger proliferative capacity and more β-catenin positive cells compared to the solid tumor. Residual cyst wall was significantly associated with tumor recurrence, and the prognosis differed between complete (GTR) and subtotal (STR) resection. The presence of tumor stem cell niches in cyst walls may contribute to recurrence.