Prognostic value of tumour associated antigen immunoreactivity and apoptosis in cerebral glioblastomas: an analysis of 168 cases.
OBJECTIVE
To evaluate a possible association between clinical outcome in patients with glioblastoma and expression of some immunohistochemical variables and apoptosis.


METHODS
168 selected patients with cerebral glioblastomas were studied retrospectively. Tumour specimens were examined immunohistochemically with antibodies to proliferating cell nuclear antigen (PCNA), p53, bcl-2, and epidermal growth factor receptor (EGFR) to detect the intracellular receptor domain. Apoptosis was detected by in situ end labelling. Multivariate analysis was performed using the Cox proportional hazard model.


RESULTS
On univariate analysis the PCNA labelling index, immunoexpression of EGFR, and the apoptotic index were significantly related to glioblastoma outcome. Survival time was reduced as PCNA labelling index increased and apoptotic index decreased (p = 0.0073 and p = 0.00031, respectively). Survival time in patients with EGFR positive tumours was found to be reduced (p = 0.00024). Multivariate analysis showed independent prognostic value for the EGFR positivity and apoptotic index only (p = 0.0053 and p = 0.0039, respectively). There was no association between clinical outcome of glioblastoma and p53 or bcl-2 immunostaining.


CONCLUSIONS
EGFR immunoreactivity and apoptotic index were found to be useful for assessing prognosis of individual glioblastomas but it seems unlikely that p53 and bcl-2 immunohistochemistry will be of value in determining survival in such patients.
Korshunov
A
A
Department of Neuropathology, Neurosurgical NN Burdenko Institute, Moscow, Russia. akorshunov@nsi.ru
Golanov
A
A
Sycheva
R
R
Pronin
I
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000951:Antigens, Neoplasm / Q000378:metabolism*; D017209:Apoptosis; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001932:Brain Neoplasms / Q000378:metabolism* / Q000473:pathology; D066246:ErbB Receptors / Q000378:metabolism; D005260:Female; D005909:Glioblastoma / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D012189:Retrospective Studies; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D018809:Proliferating Cell Nuclear Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53; D066246:ErbB Receptors