IN-VIVO PROLIFERATIVE POTENTIAL OF PRIMARY HUMAN BRAIN-TUMORS - ITS CORRELATION WITH HISTOLOGICAL CLASSIFICATION AND MORPHOLOGICAL FEATURES .2. NONGLIAL TUMORS

In-vivo cell kinetics study following peroperative intravenous infusion of bromodeoxyuridine (BrdU) was done in 10 cases of primitive neuroectodermal tumors (PNET) and 44 nonglial tumors of different histological types. The histological features usually regarded as indicators of aggressive behaviour were examined in these tumors and correlated with in-vivo labelling index (LI). In the case of meningiomas, increased cellularity, pleomorphism and mitosis had no correlation with LI. Benign non-recurrent meningiomas usually showed LI less-than-or-equal-to 1% (mean 0.6 +/- 0.3%) whereas recurrent and malignant meningioma showed higher LI (mean 2.6 +/- 0.5% and 2.8 +/- 0.4% respectively). Follow-up study suggested that meningiomas having benign histological appearance with LI > 1 % might have increased chance of recurrence. In cases of PNETs among different histological features, mitosis and differentiation seemed to be related to the biological behaviour. Astrocytic differentiation was associated with lower rate of proliferation. In pituitary adenomas different hormone producing and null cell adenomas showed similar low proliferative potential (0.6 +/- 0.3%). Benign nerve sheath tumors, craniopharyngioma and choroid plexus papilloma showed low in-vivo LI of less than 1%. Thus the present study revealed the inadequacies of routine histological examination in assessing the aggressiveness of the nonglial tumors, especially meningiomas. In-vivo LI may be a good supplement to histological diagnosis as well as helping to assess the prognosis and accordingly the management of individual cases.