title: DNA index of glial tumors in children. Correlation with tumor grade and prognosis.
abstract: BACKGROUND
  Although DNA index (DI) has prognostic significance in a variety of pediatric malignancies, there are few data regarding its utility in central nervous system (CNS) tumors. We have previously shown that patients with hyperdiploid medulloblastoma have a significantly better survival than those whose tumors are diploid. Here, we examine the effect of DI and tumor grade on the progression free survival (PFS) of 57 patients with a variety of glial neoplasms.
  
  
  METHODS
  DI was determined by flow cytometry on freshly obtained tumor tissue from the initial diagnostic specimens; a DI = 1.0 was defined as diploid (DIP), 1.0 < DI < 1.1 as near diploid (NDIP), and DI > 1.1 as hyperdiploid (HYP). Tumors were histologically graded according to the World Health Organization classification.
  
  
  RESULTS
  There were 21 Grade I tumors, 20 Grade II, 8 Grade III, and 8 Grade IV. Among the 41 low grade tumors (Grade I-II), 39 were DIP or NDIP, and 2 were HYP. Among the 16 high grade tumors (Grade III-IV), 9 were DIP, 2 NDIP, and 5 HYP. The 4-year PFS of low grade tumors was 70% (standard deviation [SD] 12%) versus 8% (SD 7%) for high grade tumors. There was a significant correlation between low grade tumor histology and a DIP/NDIP DI (P = 0.015), and univariate analysis suggested improved PFS was associated with DIP/NDIP tumors (P = 0.05). However, DI did not remain a significant prognostic factor after being stratified by tumor grade (P = 0.87).
  
  
  CONCLUSIONS
  Unlike medulloblastoma, DI is not an independent prognostic factor in pediatric glial tumors.
authors: Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-2794, USA.
authors: P
authors: P
authors: Mathew
authors: T
authors: T
authors: Look
authors: X
authors: X
authors: Luo
authors: R
authors: R
authors: Ashmun
authors: M
authors: M
authors: Nash
authors: A
authors: A
authors: Gajjar
authors: A
authors: A
authors: Walter
authors: L
authors: L
authors: Kun
authors: R L
authors: RL
authors: Heideman
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000235:genetics* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D004273:DNA, Neoplasm / Q000235:genetics*; D005260:Female; D005434:Flow Cytometry; D005910:Glioma / Q000235:genetics* / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D011003:Ploidies; D011379:Prognosis
chemical_list: D004273:DNA, Neoplasm