title: Abundance of apoptotic neoplastic cells in diagnostic biopsy samples is not a prognostic factor in childhood primitive neuroectodermal tumors of the central nervous system.
abstract: OBJECTIVE
  To assess if the abundance of apoptotic tumor cells is an independent prognostic factor in primitive neuroectodermal tumors (PNET) of the central nervous system.
  
  
  METHODS
  Formalin-fixed paraffin-embedded tumor tissue sections from 78 clinically well-characterized children with PNET were evaluated by terminal deoxytransferase-mediated deoxyuridinie-5'-triphosphate (dUTP) nick-end labeling (TUNEL). Apoptotic indices (AI) were determined by counting TUNEL-positive tumor cells either in the highest staining region (AI hot spot) or in at least 15 randomly chosen fields (AI random). The AI hot spot and AI random were then correlated with clinical variables and survival outcome.
  
  
  RESULTS
  AI hot spot (median 0.56%; range 0%-6.54%) and AI random (median 0.30%; range 0%-3.21%) showed considerable intertumor variability. Moreover, 53% of the evaluated PNET showed a more than two-fold difference between AI hot spot and AI random, showing important intratumoral variability of the abundance of apoptotic cells in a subset of the evaluated PNET. No significant associations were found between AI hot spot and AI random with clinical variables or survival outcome.
  
  
  CONCLUSIONS
  The apoptotic index does not predict survival outcome and is not specifically associated with clinical variables of prognostic significance in childhood PNET.
authors.affiliation: Division of Oncology, The Children's Hospital of Philadelphia, Pennsylvania 19104, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Grotzer
authors.forename: A J
authors.initials: AJ
authors.lastname: Janss
authors.forename: K M
authors.initials: KM
authors.lastname: Fung
authors.forename: L N
authors.initials: LN
authors.lastname: Sutton
authors.forename: H
authors.initials: H
authors.lastname: Zhao
authors.forename: J Q
authors.initials: JQ
authors.lastname: Trojanowski
authors.forename: L B
authors.initials: LB
authors.lastname: Rorke
authors.forename: P C
authors.initials: PC
authors.lastname: Phillips
mesh_terms: D017209:Apoptosis; D001706:Biopsy; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D002528:Cerebellar Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D020287:In Situ Nick-End Labeling / Q000379:methods; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000556:secondary; D009367:Neoplasm Staging; D018242:Neuroectodermal Tumors, Primitive / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D015996:Survival Rate