title: Prognostic significance of neuronal marker expression in glioblastomas.
abstract: OBJECTIVE
  Glioblastomas are the most malignant tumors of central nervous system neoplasms and are well known for their biological heterogeneity. Contrary to the putative hypothesis of purely glial differentiation in glioblastomas, they often demonstrate immunopositivity for neuronal markers. However, the significance of their neuronal marker expression is still controversial. To evaluate the prognostic implication of neuronal expression in glioblastoma, this study investigated the expression of neuronal markers in a large series of glioblastoma patients in terms of patient survival rate.
  
  
  METHODS
  Expression of synaptophysin, neurofilament protein, and NeuN was explored using immunohistochemistry in 88 cases of glioblastoma. Clinicopathological variables as well as patients' survival data were compared according to the immunopositivity of cases.
  
  
  RESULTS
  Sixty-one of the 88 tumors (69.3 %) were positive for at least one neuronal marker. Synaptophysin positivity was observed in 43 cases (48.9 %). Neurofilament protein and NeuN were positive in 38 (43.2 %) and 42 cases (47.7 %), respectively. There was no statistically significant difference in overall survival and progression-free survival in association with neuronal marker expression. However, gross total removal or combined radiotherapy and chemotherapy significantly prolonged survival (P=0.041 and 0.044). Cox's proportional hazard model revealed that NeuN expression was the independent prognostic factors in progression-free survival (P=0.012).
  
  
  CONCLUSIONS
  Although the correlation of neuronal marker expression and clinical outcome in glioblastoma is of considerable interest, the presented data support the limited prognostic value of neuronal marker expression in glioblastoma.
authors.affiliation: Department of Pathology and Center for Biomedical Human Resources (BK-21), Chonnam National University Medical School and Research Institute of Medical Sciences, 5 Hak-dong, Gwangju 501-746, Korea.
authors.forename: Kyung-Hwa
authors.initials: KH
authors.lastname: Lee
authors.forename: Kyung-Joo
authors.initials: KJ
authors.lastname: Kang
authors.forename: Kyung-Sub
authors.initials: KS
authors.lastname: Moon
authors.forename: Tae-Young
authors.initials: TY
authors.lastname: Jung
authors.forename: Shin
authors.initials: S
authors.lastname: Jung
authors.forename: Jae-Hyoo
authors.initials: JH
authors.lastname: Kim
authors.forename: Hyung-Seok
authors.initials: HS
authors.lastname: Kim
authors.forename: Min-Cheol
authors.initials: MC
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis* / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000378:metabolism*; D016900:Neurofilament Proteins; D010751:Phosphopyruvate Hydratase / Q000378:metabolism; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D016708:Synaptophysin / Q000378:metabolism; D055815:Young Adult
chemical_list: D009419:Nerve Tissue Proteins; D016900:Neurofilament Proteins; D016708:Synaptophysin; D010751:Phosphopyruvate Hydratase