Biological evaluation of biopsies from adult cerebral astrocytomas: cell-growth/cell-suicide ratios and their relationship to patient survival.
In adult cerebral astrocytomas, the more anaplasia that is present, the more malignancy that occurs. Cell proliferation antigen staining (MIB-1) and DNA labeling methods for apoptosis using paraffin sections from 39 cases were compared with histopathological grading systems for predicting patient survival. Cases were selected to include those with expected or unexpected survival time for grade. Computer-assisted image analysis data were used to construct proliferation-apoptosis indices to compare with tumor grade and patient survival. Cases with less proliferation than apoptosis usually had a favorable outcome regardless of tumor grade, with some unexpectedly long survivals among high-grade cases. Cases with more proliferation than apoptosis had a poor outcome, including most patients with high-grade astrocytomas and a few patients whose tumors were low grade but whose indices were high. The in situ tailing method for apoptosis revealed many nuclei with low levels of DNA strand breaks, particularly in older, nonsurviving patients. Tumor growth indices may be useful for prognosis and they may also become adjunctive guides for therapy by indicating rates of tumor growth and spontaneous apoptosis that therapy can affect. Perhaps the apoptotic mechanism cannot be completed spontaneously or boosted as easily by conventional therapy as patients age.
Department of Pathology, Northside Medical Center, Youngstown, Ohio 44501, USA.
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D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001254:Astrocytoma / Q000473:pathology*; D001706:Biopsy; D001932:Brain Neoplasms / Q000473:pathology*; D002455:Cell Division / Q000502:physiology; D002470:Cell Survival / Q000502:physiology; D002648:Child; D005069:Evaluation Studies as Topic; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008875:Middle Aged; D015203:Reproducibility of Results; D015996:Survival Rate