Study of the MIB-1 Labeling index as a predictor of tumor progression in pilocytic astrocytomas in children and adolescents

被引:68
作者
Bowers, DC
Gargan, L
Kapur, P
Reisch, JS
Mulne, AF
Shapiro, KN
Elterman, RD
Winick, NJ
Margraf, LR
机构
[1] Univ Texas, SW Med Ctr, SW Med Sch, Dept Pediat, Dallas, TX 75390 USA
[2] Univ Texas, SW Med Ctr, Dept Acad Comp Serv, Dallas, TX 75390 USA
[3] Univ Texas, SW Med Ctr, Dept Pathol, Dallas, TX 75390 USA
[4] Childrens Med Ctr, Neurooncol Program, Dallas, TX 75235 USA
关键词
D O I
10.1200/JCO.2003.01.017
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: The pilocytic astrocytoma (PA) is the most common childhood brain tumor. This report examines the MiB-1 labeling index (LI) as a predictor of progression-free survival (PFS) among childhood PAs. Patients and Methods: Consecutive PAs were examined to determine whether the MIB-1 LI was associated with tumor progression. Other variables evaluated included tumor location, use of adjuvant therapy, extent of resection, and age at diagnosis. Results: One hundred forty-one children were identified (mean +/- SD age, 7.6 +/- 4.7 years; range, 0.43 to 18.56 years); 118 children had adequate tissue for MIB-1 immunohistochemistry. The 5-year PFS was 61.25%. By log-rank analysis, an MIB-1 LI of more than 2.0 was associated with shortened PFS (P = .035). Patients with PAs who underwent complete surgical resection, had tumors located in the cerebellum, and were treated with surgery only also had more prolonged PFS (P = .001 for all). Tumors in the optic pathways were associated with a shorter PFS (P = .001). Restricting the evaluation of MIB-1 LI to only incompletely resected tumors revealed an insignificant trend of MIB-1 LI of more than 2.0 having a shortened PFS. Multivariate analysis demonstrated completely resected tumors and tumors located in the cerebellum as less likely to progress (P = .001 and .019, respectively). Conclusion: Children with PAs with an MIB-1 LI of more than 2.0 have a shortened PFS. PAs that are completely resected and are located in the cerebellum have a prolonged PFS. This initial study suggests that the MIB-1 LI identifies a more aggressive subset of PAs. Further work should focus on elucidating features of pilocytic astocytomas that will identify prospectively children at risk for progression.
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页码:2968 / 2973
页数:6
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