title: Ewing's sarcoma. A retrospective study of histological and immunohistochemical factors and their relation to prognosis.
abstract: Histological and immunohistochemical features of 87 patients with conventionally diagnosed Ewing's sarcoma were studied retrospectively on routinely processed material and evaluated with regard to prognostic significance. 74% were convincingly positive when stained for vimentin, 13% were doubtful, and 13% were negative. A varying degree of positivity for neuron-specific enolase (NSE) was found in 15%; these cases all co-expressed vimentin. A single tumour contained scattered cytokeratin-positive cells. Positivity for the leukocyte common antigen (LCA) could be demonstrated in three cases; these were excluded from the statistical analysis of prognostic factors. Growth pattern, soft tissue invasion, monomorphic or dimorphic cell population, and PAS-, NSE- or vimentin-positivity did not influence survival significantly. However, prognosis was increasingly poor with increasing degree of necrosis: median survival was 28 months for grade I necrosis (less than 10%), 16 months for grade II (10-50%), and 11 months for grade III (greater than 50%), p less than 0.0005. A mitosis count of less than 1 per high-powerfield (HPF) was correlated to a median survival of 26 months, greater than or equal to 1 per HPF to 12 months, p less than 0.05. The findings indicate some degree of heterogeneity in Ewing's sarcoma which may be related to primitive peripheral neuroectodermal tumours (PNETs), or be a true blastoma. In future trials, diagnostic criteria (including immunohistochemistry) should be clearly defined and materials should be large enough to allow for stratification according to prognostic factors.
authors.affiliation: Bone and Soft Tissue Tumour Centres of Copenhagen, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Daugaard
authors.forename: C
authors.initials: C
authors.lastname: Kamby
authors.forename: L M
authors.initials: LM
authors.lastname: Sunde
authors.forename: O
authors.initials: O
authors.lastname: Myhre-Jensen
authors.forename: T
authors.initials: T
authors.lastname: Schiødt
mesh_terms: D000293:Adolescent; D000328:Adult; D000943:Antigens, Differentiation / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006649:Histocompatibility Antigens / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D017493:Leukocyte Common Antigens; D008297:Male; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000032:analysis; D011379:Prognosis; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000032:analysis / Q000401:mortality / Q000473:pathology*; D014746:Vimentin / Q000032:analysis
chemical_list: D000943:Antigens, Differentiation; D006649:Histocompatibility Antigens; D014746:Vimentin; D017493:Leukocyte Common Antigens; D010751:Phosphopyruvate Hydratase