title: High expression of DNA topoisomerase IIalpha and Ki-67 antigen is associated with prolonged survival in glioblastoma patients.
abstract: Assessment of tumour cell proliferation in glioblastoma (GB) has been a topic of considerable research interest over the past decade. However, the correlation of tumour proliferation and patient outcome has yielded controversial results. In this study, we examined immunohistochemically, using paraffin-embedded tissue, the expression of the proliferation-related markers DNA topoisomerase IIalpha (TIIalpha) and Ki-67 antigen in a cohort of 114 GB patients treated consecutively with surgery and radiochemotherapy, and correlated the expression with patient outcome. The TIIalpha labelling index (LI) ranged between 5.2 and 87.2% (median: 25.6%). Survival analysis disclosed an association between high TIIalpha expression levels and prolonged survival (P=0.040, log-rank test). TIIalpha expression correlates closely with Ki-67 labelling index (R=0.927, P<0.001), which itself is predictive of patient survival (P=0.044). However, in multivariate analysis, only the Karnofsky performance status remained predictive of patient survival. We conclude that high expression of TIIalpha and Ki-67 appears to be associated with a prolonged survival in our cohort of GB patients.
authors.affiliation: Institute of Neurology, University of Vienna, AKH 4J, Währinger Gürtel 18-20, POB 48, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Bredel
authors.forename: Maria
authors.initials: M
authors.lastname: Piribauer
authors.forename: Christine
authors.initials: C
authors.lastname: Marosi
authors.forename: Peter
authors.initials: P
authors.lastname: Birner
authors.forename: Brigitte
authors.initials: B
authors.lastname: Gatterbauer
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Fischer
authors.forename: Thomas
authors.initials: T
authors.lastname: Ströbel
authors.forename: Karl
authors.initials: K
authors.lastname: Rössler
authors.forename: Herbert
authors.initials: H
authors.lastname: Budka
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Hainfellner
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality* / Q000628:therapy*; D002455:Cell Division; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D004250:DNA Topoisomerases, Type II / Q000378:metabolism*; D005909:Glioblastoma / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism*; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D019394:Ki-67 Antigen; D004250:DNA Topoisomerases, Type II