title: Proliferation- and apoptosis-related proteins in intracranial ependymomas: an immunohistochemical analysis.
abstract: As the value of grading of ependymomas is currently debated we studied the expression of proliferation- and apoptosis-related proteins in these tumors as these mechanisms both are suggested to be important in tumor growth. We characterized the immunohistochemical expression of p53, Mdm2, Bcl-2, and Bax in 51 intracranial ependymomas. We also assessed the apoptosis- and proliferation-index, measured by MIB-1, PCNA-immunohistochemistry, and analyzed the clinical parameters. Of all used antibodies, the correlation with survival and the correlation among ordered categories was assessed. None of the analyzed immunohistochemical variables were significantly correlated with tumor grade. On the other hand, PCNA, MIB-1, and p53 were significantly related to the survival of the patient. In multivariate analysis, p53 was the only independent predictive variable (p = 0.0132).
  
  
  CONCLUSIONS
  The strongest predictors of survival in univariate analysis were the expression of PCNA, MIB-1 and p53. In multivariate analysis a p53 expression > 1% showed to be significantly related with a worse survival. The predicting value of p53 expression has to be confirmed by others before solid conclusions can be made. Apoptosis seems not to be an important mechanism in tumor growth in ependymomas. The expression of Mdm2, Bcl-2, and Bax were not related to survival.
authors.affiliation: Department of Neurosurgery, Academic Medical Center, University of Amsterdam, The Netherlands. m.j.verstegen@amc.uva.nl
authors.forename: M J T
authors.initials: MJ
authors.lastname: Verstegen
authors.forename: D Troost S
authors.initials: DT
authors.lastname: Leenstra
authors.forename: H
authors.initials: H
authors.lastname: Ijlst-Keizers
authors.forename: D A
authors.initials: DA
authors.lastname: Bosch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D034961:Antigens, Nuclear; D017209:Apoptosis; D001932:Brain Neoplasms / Q000737:chemistry* / Q000401:mortality* / Q000473:pathology; D002455:Cell Division; D002648:Child; D002675:Child, Preschool; D004806:Ependymoma / Q000737:chemistry* / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D019394:Ki-67 Antigen; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000032:analysis; D011237:Predictive Value of Tests; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis; D011518:Proto-Oncogene Proteins / Q000032:analysis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D051028:bcl-2-Associated X Protein
chemical_list: D034961:Antigens, Nuclear; C494826:BAX protein, human; D019394:Ki-67 Antigen; D009687:Nuclear Proteins; D018809:Proliferating Cell Nuclear Antigen; D011518:Proto-Oncogene Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53; D051028:bcl-2-Associated X Protein