title: Proliferation not apoptosis as a prognostic indicator in retinoblastoma.
abstract: The balance between proliferation and cell death is the major determinant of tumour growth. We analysed the proliferative and apoptotic indices (PI and AI, respectively) of 33 children with retinoblastoma. PI and AI were assessed by immunohistochemistry for Ki-67 antigen and TUNEL staining, respectively. The mean PI was 21.0+/-21.1%, and higher PI was associated with more advanced tumour stage (P<0.0001) and poor clinical outcome (P<0.05). Patients in whom amplified N-myc oncogene was found (n=6) determined by the multiplex polymerase chain reaction tended to have a higher PI (37.6+/-27.2%) than those without amplified N-myc (n=27; PI=17.3+/-18.1). A PI value of over 40% was clearly associated with an unfavourable prognosis. The AI, however, did not correlate with any of the other variables analysed. The findings suggest that proliferation, but not apoptosis, is of critical significance in retinoblastoma biology. PI, as determined by the Ki-67 antigen labelling index, seems to be a relevant histopathological parameter that can predict the clinical outcome of retinoblastoma.
authors.affiliation: Department of Pathology, Seoul National University College of Medicine, Korea. cjkim@plaza.snu.ac.kr
authors.forename: C J
authors.initials: CJ
authors.lastname: Kim
authors.forename: J G
authors.initials: JG
authors.lastname: Chi
authors.forename: H S
authors.initials: HS
authors.lastname: Choi
authors.forename: H Y
authors.initials: HY
authors.lastname: Shin
authors.forename: H S
authors.initials: HS
authors.lastname: Ahn
authors.forename: Y S
authors.initials: YS
authors.lastname: Yoo
authors.forename: K Y
authors.initials: KY
authors.lastname: Chang
mesh_terms: D017209:Apoptosis; D002455:Cell Division; D002648:Child; D002675:Child, Preschool; D053938:DNA Fragmentation; D017931:DNA Primers / Q000737:chemistry; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D020287:In Situ Nick-End Labeling; D007223:Infant; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D016133:Polymerase Chain Reaction; D011379:Prognosis; D019572:Retinal Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000401:mortality; D012175:Retinoblastoma / Q000737:chemistry / Q000175:diagnosis* / Q000401:mortality; D015996:Survival Rate
chemical_list: D017931:DNA Primers; D004273:DNA, Neoplasm; D019394:Ki-67 Antigen