Proliferative activity as measured by MIB-1 labeling index and long-term outcome of visual pathway astrocytomas in children

被引:13
作者
Czech, T
Slavc, I
Aichholzer, M
Haberler, C
Dietrich, W
Dieckmann, K
Koos, W
Budka, H
机构
[1] Univ Vienna, Dept Neurosurg, A-1090 Vienna, Austria
[2] Univ Vienna, Dept Pediat, A-1090 Vienna, Austria
[3] Univ Vienna, Inst Neurol, A-1090 Vienna, Austria
[4] Univ Vienna, Dept Radiotherapy, A-1090 Vienna, Austria
关键词
visual pathway glioma; MIB-1 labeling index; leptomeningeal spread; radiotherapy; anaplastic transformation;
D O I
10.1023/A:1006244724476
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Although most visual pathway tumors are low-grade gliomas their biologic behavior is highly unpredictable. In order to determine whether assessment of proliferative activity can assist in predicting tumor behavior, we studied the MIB-1 labeling indices (MIB-1 LIs) in surgical specimens and monitored tumor growth in 31 consecutive children operated on between 1978 and 1997. The MIB-1 LIs at diagnosis varied from 0-10.6% (mean +/- SD, 3.27 +/- 2.49%). Tumor progression occurred in 19 patients leading to death in seven, three of whom had neurofibromatosis type 1 (NF1). No association between MIB-1 LI at initial diagnosis and both progression free and overall survival was apparent. However, the MIB-1 LIs increased to 15.2% and 18% in two patients with NF1 who developed highly malignant gliomas 6 and 6.5 years after irradiation. In the remaining patients the MIB-1 LIs did not change significantly over time in a total of 17 repeat surgeries. Three patients with LIs of 6.8%, 10.6% and 8.8% are stable after 6, 4.5 and 3.5 years with partial resection, biopsy and subtotal resection, respectively, and no further therapy in the first two and chemotherapy in the latter. Three patients (10%) with LIs of 6.4%, 4.8% and 2.2% either presented with or developed leptomeningeal spread during follow-up. While MIB-1 LI does not appear to assist in clinical decision making patient numbers were too small to find out whether response to chemotherapy varies with proliferative potential.
引用
收藏
页码:143 / 150
页数:8
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