Glioblastoma is one of the most serious and aggressive forms of brain tumor. In Germany, it is one of the challenges of modern medicine because it grows quickly and is difficult to treat. Laboratory medicine plays an important role in precisely identifying the tumor, understanding its characteristics and planning treatment. But what exactly is a glioblastoma, how is it diagnosed and why is laboratory analysis so crucial? This article explains it simply and clearly.

What is a glioblastoma?

A glioblastoma is a malignant tumor that develops in the brain or, rarely, in the spinal cord. It belongs to the so-called gliomas, tumors that arise from the supporting cells of the nervous system (glial cells). What makes it particularly dangerous is its rapid growth and its ability to invade surrounding brain tissue. In Germany, it is usually diagnosed in adults between the ages of 50 and 70, with men being affected slightly more frequently. The causes are not fully understood – genetic changes and, in rare cases, exposure to radiation are considered risk factors.

Symptoms that sound the alarm

As the glioblastoma grows in the brain, it presses on nerves and impairs their function. Typical signs are severe headaches that are worse in the morning, nausea, epileptic seizures, memory problems or weakness in the arms and legs. These symptoms depend on where the tumor is located. Because they could also have other causes, an accurate diagnosis is essential – and this is where the journey through laboratory medicine begins.

The path to diagnosis

The determination of a glioblastoma does not start directly in the laboratory, but with imaging procedures such as MRI (magnetic resonance imaging) or CT (computed tomography). These show whether a tumor is present and where it is located. However, to know for sure that it is a glioblastoma and how aggressive it is, a tissue sample is required. This is usually obtained through surgery or a stereotactic biopsy – a procedure in which a piece of tumor is specifically removed with the help of 3D images. The sample then ends up in the laboratory, where the actual analysis begins.

Laboratory medical examinations

In Germany, laboratory medicine uses various methods to examine glioblastoma in detail:

1. Histology:
   The tissue sample is examined under a microscope. Pathologists look at what the cells look like – in glioblastoma they are often irregular, large and divide quickly. Areas of dead tissue (necrosis) and many new blood vessels that supply the tumor are also typical.
   
2. Grading (WHO classification):
   Glioblastomas are classified as grade IV, the highest grade according to the World Health Organization (WHO). This shows how malignant and aggressive they are. Laboratory analysis confirms this grade based on the cell structure and growth rate.
   
3. Molecular markers:
   Modern laboratory medicine goes beyond the microscope. Genetic changes in the tumor are examined, e.g. the MGMT status (a gene that influences the effect of chemotherapy) or mutations in the IDH gene. IDH wild-type glioblastomas (without mutations) are more common and more aggressive, while IDH-mutated glioblastomas are rarer and have a slightly better prognosis. These markers help to customize the therapy.
   
4. Immunohistochemistry:
   Special staining techniques are used to visualize proteins in tumour tissue, which provide further information on the type of tumour and its behaviour. This supports the diagnosis and shows how the tumor might react to treatment.
   
5. Cerebrospinal fluid analysis (if required):
   If the tumor is close to the cerebrospinal fluid or metastases are suspected, a lumbar puncture can be performed. The cerebrospinal fluid is used to look for tumor cells or other abnormalities.

Why is laboratory medicine so important?

Without laboratory medicine, a glioblastoma would be difficult to distinguish from other brain tumors or diseases. The precise analysis of the tissue sample provides clarity about the diagnosis and provides crucial information for the therapy. In Germany, this is particularly important because the treatment – usually a combination of surgery, radiotherapy and chemotherapy – is planned individually. Molecular markers such as the MGMT status can show, for example, whether chemotherapy with temozolomide could be effective. In this way, laboratory medicine not only helps with diagnosis, but also with creating the best chances for the patient.

The challenge of forecasting

Despite all the progress made, the prognosis for glioblastoma remains difficult. In Germany, the average life expectancy after diagnosis is around 12 to 18 months, although there are exceptions thanks to modern therapies. The laboratory results help to better assess the course of the disease and maintain quality of life for as long as possible.

Conclusion

Glioblastoma is a dreaded enemy, but laboratory medicine in Germany provides doctors with valuable tools to detect and combat it. From tissue analysis to the examination of genetic markers – laboratory tests are the key to providing clarity and guiding therapy. Even if the chances of a cure are limited, precise diagnostics enable targeted treatment that can give time and hope. A complex field that shows how important laboratory medicine is for modern medicine!

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Editorial office: X-Press Journalistenbüro GbR

Gender note. The personal designations used in this text always refer equally to female, male and diverse persons. Double/triple references and gendered designations are avoided for the sake of better readability ected.