title: Classification of microvascular patterns via cluster analysis reveals their prognostic significance in glioblastoma.
abstract: There are limited researches focusing on microvascular patterns (MVPs) in human glioblastoma and their prognostic impact. We evaluated MVPs of 78 glioblastomas by CD34/periodic acid-Schiff dual staining and by cluster analysis of the percentage of microvascular area for distinct microvascular formations. The distribution of 5 types of basic microvascular formations, that is, microvascular sprouting (MS), vascular cluster (VC), vascular garland (VG), glomeruloid vascular proliferation (GVP), and vasculogenic mimicry (VM), was variable. Accordingly, cluster analysis classified MVPs into 2 types: type I MVP displayed prominent MSs and VCs, whereas type II MVP had numerous VGs, GVPs, and VMs. By analyzing the proportion of microvascular area for each type of formation, we determined that glioblastomas with few MSs and VCs had many GVPs and VMs, and vice versa. VG seemed to be a transitional type of formation. In case of type I MVP, expression of Ki-67 and p53 but not MGMT was significantly higher as compared with those of type II MVP (P < .05). Survival analysis showed that the type of MVPs presented as an independent prognostic factor of progression-free survival (PFS) and overall survival (OS) (both P < .001). Type II MVP had a more negative influence on PFS and OS than did type I MVP. We conclude that the heterogeneous MVPs in glioblastoma can be categorized properly by certain histopathologic and statistical analyses and may influence clinical outcome.
authors.affiliation: Tumor Invasion Microecological Laboratory, Fujian Medical University, Fuzhou 350005, China; Intensive Care Unit, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
authors.forename: Long
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China. Electronic address: lzx1967@sina.com.
authors.forename: Zhi-Xiong
authors.initials: ZX
authors.lastname: Lin
authors.affiliation: Department of Neurosurgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
authors.forename: Guo-Shi
authors.initials: GS
authors.lastname: Lin
authors.affiliation: Department of Neurosurgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
authors.forename: Chang-Fu
authors.initials: CF
authors.lastname: Zhou
authors.affiliation: Department of Pathology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
authors.forename: Yu-Peng
authors.initials: YP
authors.lastname: Chen
authors.affiliation: Department of Pathology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
authors.forename: Xing-Fu
authors.initials: XF
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
authors.forename: Zong-Qing
authors.initials: ZQ
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000032:analysis; D001706:Biopsy; D001932:Brain Neoplasms / Q000098:blood supply* / Q000737:chemistry / Q000145:classification / Q000401:mortality / Q000473:pathology; D016000:Cluster Analysis; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000098:blood supply* / Q000737:chemistry / Q000145:classification / Q000401:mortality / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D055806:Microvessels / Q000737:chemistry / Q000473:pathology*; D008875:Middle Aged; D009389:Neovascularization, Pathologic; D010363:Pattern Recognition, Automated; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D055815:Young Adult
chemical_list: D018952:Antigens, CD34; D019394:Ki-67 Antigen; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53
keywords: Angiogenesis; Cluster analysis; Glioblastoma; Microvascular patterns; Morphology; Prognosis