title: DNA topoisomerase II-alpha as a proliferation marker in human gliomas: correlation with PCNA expression and patient survival.
abstract: OBJECTIVE
  DNA topoisomerase II-alpha (Topo-IIalpha) is the inducible form of the enzyme responsible for the first step in the modification of DNA topology. Topo-IIalpha upregulation has been demonstrated in different tumors. Topo-IIalpha products may modulate tumoral growth, metastasis and immunosuppression, inhibit apoptosis and cause resistance to chemotherapy. Moreover, the antitumoral effect ofTopo-IIalpha inhibitors has been documented.
  
  
  METHODS
  We studied the immunohistochemical expression and the prognostic value of Topo-IIalpha on 57 surgical specimens ofglioma. Furthermore, we evaluated the correlation between the immunohistochemical expression of Topo-IIalpha and proliferating cell nuclear antigen (PCNA).
  
  
  RESULTS
  A statistically significant correlation with survival time was found, there was no statistically significant difference in survival between patients receiving or not receiving carmustine-based combined chemotherapy (p > 0.05), regardless of histological type. A significant correlation between Topo-IIalpha and PCNA was documented (r = 0.9245, p < 0.001).
  
  
  CONCLUSIONS
  Our findings show that gliomas immunohistochemically express Topo-IIalpha that is correlated with PCNA expression, and which is significantly less frequent in long survivors. The presence of a statistical correlation with survival time and tumor histological grade encourages further studies on a larger series to verify the prognostic value of Topo-IIalpha expression in gliomas.
authors.affiliation: Department of Neurosurgery, The Second Affiliated Hospital (Shengjing Hospital), China Medical University, Heping District, Shenyang, China.
authors.forename: H
authors.initials: H
authors.lastname: Zhao
authors.forename: H
authors.initials: H
authors.lastname: Yu
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.forename: W
authors.initials: W
authors.lastname: Cai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000096:biosynthesis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001932:Brain Neoplasms / Q000201:enzymology* / Q000401:mortality; D049109:Cell Proliferation; D002648:Child; D004250:DNA Topoisomerases, Type II / Q000096:biosynthesis*; D004268:DNA-Binding Proteins / Q000096:biosynthesis*; D005260:Female; D015870:Gene Expression; D005910:Glioma / Q000201:enzymology* / Q000401:mortality; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000096:biosynthesis*
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; D018809:Proliferating Cell Nuclear Antigen; D004250:DNA Topoisomerases, Type II