Journal of Histopathology and Cytopathology
Official Journal of Bangladesh Academy of Pathology
Vol 10, No 1, January 2026
Expression of FLI1 in Astrocytoma and its Association with WHO Grade
*Sultana S,1 Rahiduzzaman SM,2 Yeamin MA,3 Rashid HO,4 Akter J,5 Islam M,6 Jeba R7
Abstract
Background: Astrocytoma is one of the most common glial tumors of the central nervous system. Prognosis and treatment modalities for astrocytoma vary according to their grades. Understanding the biological behavior of tumors and their sensitivity to chemotherapy or radiotherapy is difficult through histopathological grading alone. The transcription factor Friend leukemia virus integration 1 (FLI1) is abnormally expressed in astrocytoma and is associated with tumor grade.
Objective: To see FLI1 expression in astrocytoma and its association with WHO grade.
Methodology: It was a cross-sectional observational study conducted with 50 samples selected using purposive sampling technique at the Department of Pathology of Dhaka Medical College. The samples were drawn from histologically diagnosed astrocytoma cases within the period from March 2022 to February 2024. These samples were categorized into histopathological grades according to the WHO classification 2016. The collected 50 paraffin blocks were sectioned, stained with hematoxylin and eosin (H&E). Immunostaining with FLI1 was done in all cases. Relevant information was collected and recorded in a predesigned data sheet. Statistical analysis was carried out as required.
Results: Among total 50 cases, the patients’ ages ranged from 4 to 92 years, with a mean age of 37.8 ± 19.9 years. The male-to-female ratio was 1.5:1. Among total 50 cases grade IV tumor was 36% followed by Grade I tumors (22.0%) and Grade II tumors (22.0%). The majority of cases exhibited high expression (FLI1 score ≥4) at 74.0%, while the remaining cases showed low expression (FLI1 score ≤3) at 26.0%. Grade I and II tumors mostly displayed low FLI1 expression, whereas grade III and IV tumors predominantly exhibited high FLI1 expression. Among the cases with high FLI1 expression, the majority were grade IV tumors (45.9%), followed by grade III tumors (27.0%). Conversely, among the cases 26% with low FLI1 expression, the majority were grade I (46.2%) and grade II tumors (46.2%). The calculated p-value (<0.001) emphasizes the statistical significance of this association.
Conclusion: The results of this study indicate positive association of FLI1 expression with WHO grade in astrocytoma. Low expression of FLI1 was observed in low- grade astrocytomas and high expression of FLI1 was observed in high-grade astrocytoma.
[Journal of Histopathology and Cytopathology, 2026 Jan; 10 (1):27-37]
DOI: https://www.doi.org/10.69950/jhc.2026.10.1.4
Keywords: Astrocytoma, FLI1 expression, WHO Grade.
- *Dr. Shahana Sultana, MBBS, MD (Pathology), Assistant Professor, Green Life Medical College, Dhaka, shahanashova935@gmail.com,
- Dr. S.M. Rahiduzzaman, MBBS, MD (Cardiology), Resident, Sir Salimullah Medical College, Dhaka. rahid39rpmc@gmail.com
- Dr. Dr. Md. Abdullah Yeamin, MBBS, MD (Pathology),Lecturer, Jashore Medical College, Jashore. peyal4794@gmail.com
- Dr, Harun Or Rashid, MBBS, MD (Pathology), Lecturer, Shaheed M Monsur Ali Medical College, Sirajgonj. drharunorrashidjewel@gmail.com
- Dr. Dr. Jhuma Akter, MBBS, MD (Pathology), Pathologist, Dhaka Medical College, Dhaka, jhuma.kmc@gmail.com
- Dr, Mainul Islam, MBBS, MD (Pathology), Assistant Professor, Department of Pathology, Dhaka Medical College, Dhaka. mainul.62.34@gmail.com
- Dr. Ruksana Jeba, MBBS, MD (Pathology), Professor and head, Department of Pathology, Dhaka Medical College, Dhaka, ruksanajeba67@gmail.com
*For correspondence