Immunohistochemical expression of ATRX in glioma and its correlation with age,sex,tumor grade, and IDH status.

Background: Gliomas are tumors deriving from glia cells and cause significant cancer mortality globally. Alpha-thalassemia/mental retardation syndrome X-linked (ATRX) mutations are frequently distinguished in gliomas.There are increasing indications to study the ATRX protein immunohistochemically to enhance knowledge about diagnosis, therapy, and prognosis.Objective:to determine the association between ATRX expression and different clinicopathological parameters in gliomas including age ,sex, tumor grade and IDH status.Materials and methods:This cross-sectional retrospective study was carried out in the Department of Pathology and Forensic Medicine, Faculty of Medicine, University of Babylon, during the period from January 2023 through December 2023. Fifty formalin-fixed and paraffin-embedded tissue blocks of patients diagnosed with glioma have been obtained from the laboratory of histopathology in Al-Kafeel Specialized Hospital, Karbala, for the last five years (2019–2023), and different clinicopathological parameters have been correlated with ATRX expression.Results:Loss of nuclear ATRX expression in tumor cells was observed in 37 cases (74%), while retained expression was observed in 13 cases (36%). Loss of ATRX was mostly observed in the age group of 31–40 years,while retained expression was mostly observed in age group of 61–70 years, and there was a significant association between ATRX expression and the age groups. Regarding sex, most of cases were males (54%), and there was no significant association between ATRX expression and sex.concerning tumor grade, loss of ATRX expression was observed mostly (100%) in grade 2 tumors, and there was a significant association. There was a significant association between ATRX and IDH expressionConclusions: Loss of nuclear ATRX expression is associated with younger patient age and a lower grade of glioma, and there is an association between IDH mutation (mutant type) and loss of ATRX expression.