ArticleThe journal of pathology. Clinical research2026
SOX10 distinguishes oligodendrogliomas from low-grade glioneuronal tumors/low-grade gliomas with oligodendrocyte-like features.
Article in The journal of pathology. Clinical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Oligodendrogliomas exhibit significant morphological overlap with low-grade glioneuronal tumors/low-grade gliomas with oligodendrocyte-like features, posing challenges in histopathological diagnosis. SOX10, a transcription factor critical for oligodendrocyte maturation and central nervous system myelination, may serve as a diagnostic marker. We evaluated the diagnostic utility of SOX10 immunohistochemical expression in 300 oligodendrogliomas versus 52 low-grade glioneuronal tumors/low-grade gliomas with oligodendrocyte-like features. Notably, SOX10 was negative in 251/300 (83.7%) oligodendrogliomas but diffusely positive in 47/52 (90.4%) low-grade glioneuronal tumors/low-grade gliomas with oligodendrocyte-like features (except polymorphous low-grade neuroepithelial tumors of the young, PLNTY). SOX10 expression was significantly higher in the latter group (p < 0.001) and showed a WHO grade dependent up-regulation in oligodendrogliomas (p < 0.001). The diagnostic utility of SOX10 was evident in IDH1-immunonegative cases, yielding 72% sensitivity, 90.4% specificity, and a 78.3% positive predictive value for oligodendroglioma. Combining H3K27me3 loss with SOX10 negativity markedly improved diagnostic sensitivity for oligodendroglioma to 88.5%, substantially surpassing the 35% sensitivity achieved with H3K27me3 loss alone. Additionally, an immunohistochemical panel comprising SOX10, Olig2, and IDH1 aided in discriminating non-neoplastic oligodendrocyte hyperplasia from oligodendroglioma and evaluating the presence of peritumoral tumor residue, particularly in IDH1-immunonegative oligodendroglioma. In conclusion, SOX10 negativity effectively excludes low-grade glioneuronal tumors/low-grade gliomas with oligodendrocyte-like features (except PLNTY) and non-neoplastic oligodendrocyte hyperplasia from oligodendrogliomas. SOX10 serves as a specific diagnostic marker, enhancing pathological diagnostic accuracy.
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