title: Ki-67 overexpression in WHO grade II gliomas is associated with poor postoperative seizure control.
abstract: OBJECTIVE
  Seizures are the most common initial symptom in patients with low-grade gliomas, and approximately 30% of these patients still suffer from epilepsy after gross-total resection of the tumour. We examined the relationship between the overexpression of ki-67 in WHO grade II gliomas and seizure control.
  
  
  METHODS
  A series of 93 histologically confirmed WHO grade II glioma tissues were analysed through immunohistochemical staining for ki-67 expression. Follow-up visits regarding seizure control were scheduled at 12 months. The Engel classification was used to categorise patients' seizure status.
  
  
  RESULTS
  Of the 93 patients analysed, 65 (66.3%) patients initially presented with seizures. A total of 36 patients were diagnosed with WHO grade II oligodendrogliomas, 29 patients had oligoastrocytomas and 28 patients had astrocytomas. Ki-67 was over-expressed in 15 patients. One year after surgery poor seizure control was observed in 11 of these patients. In contrast, low ki-67 expression (<10%) was found in 78 patients. Poor seizure control was observed in 36 patients (difference between ki-67 over- and low expression groups P = 0.002). Logistic regression analysis revealed that patients with gross-total resection achieved better seizure control while ki-67 overexpression and age below 38 years were poor seizure control factors explained of the variance of seizure outcome (OR: 0.382, 4.354 and 1.822, respectively).
  
  
  CONCLUSIONS
  In WHO grade II gliomas, Ki-67 is a molecular marker which predicts poor seizure control of glioma patients after the resection of the tumour. Gross-total resection, ki-67 overexpression and age below 38 years significantly affect seizure prognosis.
authors.affiliation: Department of Neurosurgery, West China Hospital of Sichuan university, 610041 Chengdu, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yuan
authors.forename: Wang
authors.initials: W
authors.lastname: Xiang
authors.forename: Liu
authors.initials: L
authors.lastname: Yanhui
authors.forename: Liang
authors.initials: L
authors.lastname: Ruofei
authors.forename: Liu
authors.initials: L
authors.lastname: Shuang
authors.forename: Fan
authors.initials: F
authors.lastname: Yingjun
authors.forename: Zhou
authors.initials: Z
authors.lastname: Qiao
authors.forename: Yang
authors.initials: Y
authors.lastname: Yanwu
authors.forename: Mao
authors.initials: M
authors.lastname: Qing
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000150:complications / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D005260:Female; D005910:Glioma / Q000150:complications / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011184:Postoperative Period; D011379:Prognosis; D012640:Seizures / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D019394:Ki-67 Antigen
keywords: Engel classification; Glioma; Ki-67; Seizure