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Vartholomatos E, Vartholomatos G, Alexiou GA, Markopoulos GS. The Past, Present and Future of Flow Cytometry in Central Nervous System Malignancies. Methods Protoc 2021; 4:mps4010011. [PMID: 33530325 PMCID: PMC7839046 DOI: 10.3390/mps4010011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 01/22/2021] [Accepted: 01/22/2021] [Indexed: 02/06/2023] Open
Abstract
Central nervous system malignancies (CNSMs) are categorized among the most aggressive and deadly types of cancer. The low median survival in patients with CNSMs is partly explained by the objective difficulties of brain surgeries as well as by the acquired chemoresistance of CNSM cells. Flow Cytometry is an analytical technique with the ability to quantify cell phenotype and to categorize cell populations on the basis of their characteristics. In the current review, we summarize the Flow Cytometry methodologies that have been used to study different phenotypic aspects of CNSMs. These include DNA content analysis for the determination of malignancy status and phenotypic characterization, as well as the methodologies used during the development of novel therapeutic agents. We conclude with the historical and current utility of Flow Cytometry in the field, and we propose how we can exploit current and possible future methodologies in the battle against this dreadful type of malignancy.
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Affiliation(s)
- Evrysthenis Vartholomatos
- Faculty of Medicine, Neurosurgical Institute, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (E.V.); (G.A.A.)
| | - George Vartholomatos
- Haematology Laboratory-Unit of Molecular Biology, University Hospital of Ioannina, 45110 Ioannina, Greece;
| | - George A. Alexiou
- Faculty of Medicine, Neurosurgical Institute, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (E.V.); (G.A.A.)
- Department of Neurosurgery, University of Ioannina, 45110 Ioannina, Greece
| | - Georgios S. Markopoulos
- Faculty of Medicine, Neurosurgical Institute, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (E.V.); (G.A.A.)
- Haematology Laboratory-Unit of Molecular Biology, University Hospital of Ioannina, 45110 Ioannina, Greece;
- Correspondence:
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Lin YW, Tai SH, Chang CC, Chao LC, Wen MJ, Huang YH, Hung HY, Lee EJ. Application of flow cytometry for evaluating clinical prognosis and histopathological grade of human glioma. Neurol Res 2016; 38:625-33. [PMID: 27264544 DOI: 10.1080/01616412.2016.1190119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Flow cytometry was applied to predict the biological parameters of tumor behavior based on the DNA content distribution of tumors. We used flow cytometry to determine the number of cell cycles for the characterization of intracranial gliomas and its possible prognostic role. METHODS Flow cytometric analysis of the DNA content was performed for 37 fresh operative glioma specimens. The expression of Ki-67 in glioma specimens was detected using immunohistochemistry staining. The check points of G2/M-phase fractions, cyclin B, and pCdk1 (Y15) were analyzed using Western immunoblotting. RESULTS Compared to low-grade (grade I/II) gliomas, significant differences in the Ki-67, cyclin B, G2/M-phase, and S+G2/M-phase expressions were found in high-grade (grade III/IV) gliomas. Furthermore, receiver operating characteristic (ROC) analysis indicated optimal cutoff points for the G2/M-phase and S+G2/M-phase fractions of 13.47 and 17.26%, respectively, which can be used to differentiate cases with low- and high-grade gliomas. Additionally, both G2/M-phase and S+G2/M-phase fractions had significant association with the expression of Ki-67 in the gliomas. The gliomas were classified by the DNA content. We found that patients with high-grade glioma had worse survival rate than patients with low-grade glioma. Meanwhile, ROC curve analysis gave cutoffs for G2/M-phase of 9.4% and for S+G2/M-phase fractions of 15.04% as best predicting survival. The patients with glioma had poor survival when the levels of G2/M-phase and S+G2/M-phase were more than 9.4 and 15.04%, respectively. In contrast, no significant association between the DNA content of glioma patients and their age, tumor recurrence, and tumor size was found. DISCUSSION Our results indicate that flow cytometry analysis for G2/M-phase and S+G2/M-phase fractions can be used for tumor grading for rapidly differentiating low- from high-grade gliomas.
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Affiliation(s)
- Yu-Wen Lin
- a Neurophysiology Laboratory, Department of Surgery , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Shih-Huang Tai
- a Neurophysiology Laboratory, Department of Surgery , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Che-Chao Chang
- a Neurophysiology Laboratory, Department of Surgery , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Liang-Chun Chao
- a Neurophysiology Laboratory, Department of Surgery , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Miin-Jye Wen
- b Department of Statistics , College of Management, National Cheng Kung University , Tainan , Taiwan
| | - Yu-Hsuan Huang
- a Neurophysiology Laboratory, Department of Surgery , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Hsin-Yi Hung
- c School of Pharmacy , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
| | - E-Jian Lee
- a Neurophysiology Laboratory, Department of Surgery , National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University , Tainan , Taiwan
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Lin YW, Tai SH, Huang YH, Chang CC, Juan WS, Chao LC, Wen MJ, Hung YC, Lee EJ. The application of flow cytometry for evaluating biological aggressiveness of intracranial meningiomas. CYTOMETRY PART B-CLINICAL CYTOMETRY 2014; 88:312-9. [DOI: 10.1002/cyto.b.21202] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 11/04/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Yu-Wen Lin
- Neurophysiology Laboratory; Department of Surgery; National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University; Tainan Taiwan
| | - Shih-Huang Tai
- Neurophysiology Laboratory; Department of Surgery; National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University; Tainan Taiwan
| | - Yu-Hsuan Huang
- Neurophysiology Laboratory; Department of Surgery; National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University; Tainan Taiwan
| | - Che-Chao Chang
- Neurophysiology Laboratory; Department of Surgery; National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University; Tainan Taiwan
| | - Wei-Sheng Juan
- Neurophysiology Laboratory; Department of Surgery; National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University; Tainan Taiwan
| | - Liang-Chun Chao
- Neurophysiology Laboratory; Department of Surgery; National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University; Tainan Taiwan
| | - Miin-Jye Wen
- Department of Statistics; College of Management, National Cheng-Kung University; Tainan Taiwan
| | - Yu-Chang Hung
- Neurophysiology Laboratory; Department of Surgery; National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University; Tainan Taiwan
| | - E-Jian Lee
- Neurophysiology Laboratory; Department of Surgery; National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University; Tainan Taiwan
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4
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Shioyama T, Muragaki Y, Maruyama T, Komori T, Iseki H. Intraoperative flow cytometry analysis of glioma tissue for rapid determination of tumor presence and its histopathological grade. J Neurosurg 2013; 118:1232-8. [DOI: 10.3171/2013.1.jns12681] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
Intraoperative histopathological investigation plays an important role during surgery for gliomas. To facilitate the rapid characterization of resected tissue, an original technique of intraoperative flow cytometry (iFC) was established. The objective in this study was evaluation of this technique's efficacy for rapidly determining tumor presence in the surgical biopsy sample and WHO histopathological grade of the neoplasm.
Methods
In total, 328 separate biopsy specimens obtained during the resection of 81 intracranial gliomas were analyzed with iFC. The evaluated malignancy index (MI) was defined as the ratio of the number of cells with greater than normal DNA content to the total number of cells. The duration of iFC in all cases was approximately 10 minutes. Each sample was additionally investigated histopathologically on frozen and permanent formalin-fixed paraffin-embedded tissue sections. The latter process was used as a “gold standard” control for evaluation of the diagnostic efficacy of iFC analysis.
Results
The MI differed significantly between neoplastic and perilesional brain tissue (25.3% ± 22.0% vs 4.6% ± 2.6%, p < 0.01). Receiver operating characteristic curve analysis revealed a corresponding area under the curve value of 0.941. The optimal cutoff level of the MI for identification of tumor in the biopsy specimen was 6.8%, which provided 0.88 sensitivity, 0.88 specificity, 0.97 positive predictive value, 0.60 negative predictive value, and 0.88 diagnostic accuracy. Additionally, the MI showed a significant association with WHO histopathological grades of glioma (p < 0.01), but its values in Grade II, III, and IV tumors overlapped prominently and were on average 13.3% ± 11.0%, 35.0% ± 21.8%, and 46.6% ± 23.1%, respectively.
Conclusions
Results of this study demonstrate that iFC with the determination of the MI may be feasible for rapidly determining glioma presence in a surgical biopsy sample.
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Affiliation(s)
- Takahiro Shioyama
- 1Institute of Advanced Biomedical Engineering and Science
- 6Nihon Kohden Corporation, Tokyo, Japan
| | - Yoshihiro Muragaki
- 2Faculty of Advanced Techno-Surgery, Graduate School of Medicine
- 3Departments of Neurosurgery and
| | - Takashi Maruyama
- 2Faculty of Advanced Techno-Surgery, Graduate School of Medicine
- 3Departments of Neurosurgery and
| | - Takashi Komori
- 1Institute of Advanced Biomedical Engineering and Science
- 4Pathology, Tokyo Women's Medical University
- 5Laboratory of Brain Tumor Pathology, Department of Brain Development and Regeneration, Tokyo Metropolitan Institute of Medical Science; and
| | - Hiroshi Iseki
- 2Faculty of Advanced Techno-Surgery, Graduate School of Medicine
- 3Departments of Neurosurgery and
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Quiñones-Hinojosa A, Sanai N, Smith JS, McDermott MW. Techniques to assess the proliferative potential of brain tumors. J Neurooncol 2005; 74:19-30. [PMID: 16078103 DOI: 10.1007/s11060-004-5758-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Assessment of brain tumor proliferative potential provides important prognostic information that supplements standard histopathologic grading. Many laboratories rely on mitotic figures to quantify the proliferative potential of brain tumors, but this conventional cellular proliferative index is subject to inter-observer variability and not consistently predictive for low-and high-grade tumors. Recent advancements in technology have made it possible to use proliferative indices as a standard supplement in pathology laboratories. Non-invasive tumor tissue measurements of cell proliferation can be performed using- bromodeoxyuridine labeling index (BrdU LI), flow cytometry (FCM), MIB-1 antibody to the Ki-67 antigen (MIB-1), proliferating cell nuclear antigen (PCNA), and argyrophilic nucleolar organizing regions (AgNOR). Each of these assays has been described in the literature with respect to its ability to predict tumor grade or outcome. At the present time MIB-1 and AgNOR are the simplest and most reliable of these techniques. In addition, advances in our understanding of the genetic alterations associated with proliferation promise to provide more specific markers of proliferative potential. Beyond the pathology laboratory, radiographic studies such as positron emission tomography (PET), single photon emission computed tomography (SPECT), and most recently magnetic resonance spectroscopy (MRS) have been used as follow-up measures, assessing response to treatment and tumor recurrence, rather than as predictors of response to treatment. These radiographic tools, however, have the potential to provide an assessment of tumor proliferation without the need for invasive measures. In this article, we present a review of the current techniques utilized to understand the proliferative potential of brain tumors.
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Affiliation(s)
- Alfredo Quiñones-Hinojosa
- Department of Neurological Surgery, and Brain Tumor Research Center, University of California, San Francisco, 505 Parnassus Avenue, Moffitt Hospital Room M779, Box 0112, San Francisco, CA 94143-0112, USA.
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Reavey-Cantwell JF, Haroun RI, Zahurak M, Clatterbuck RE, Parker RJ, Mehta R, Fruehauf JP, Brem H. The prognostic value of tumor markers in patients with glioblastoma multiforme: analysis of 32 patients and review of the literature. J Neurooncol 2001; 55:195-204. [PMID: 11859975 DOI: 10.1023/a:1013845004294] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Although several studies have examined brain tumor markers for prognostic value, few investigations have stratified analysis based on specific histologic grade. The objective of this study was to evaluate a single histologic grade of glioma, the grade IV glioma or glioblastoma (World Health Organization Classification), with a comprehensive panel of tumor markers in an attempt to identify those with prognostic significance. Tumor samples from a cohort of patients with glioblastoma multiforme (n = 32) were examined for tumor markers, DNA analysis, and clinical variables in an attempt to determine a 'profile' for this tumor. We used univariate and multivariate statistical analysis to determine the prognostic value of tumor cell ploidy, percent S-phase, DNA index, p53, and Ki-67 labeling index, as well as the variables of gender, race, age, location of tumor, history of chemotherapy, and primary versus recurrent tumor. Two additional tumor markers, multidrug resistance gene 1 and glutathione-S-transferase subtype pi, were included in the sample testing, but were not analyzed statistically. Univariate analysis indicated that increasing age had a strong association with decreased survival. Female gender, increasing Ki-67, no chemotherapy before sample collection, and primary glioblastoma showed some association with decreased survival in the univariate model. The univariate results indicated that race, side of tumor, ploidy, S-phase, DNA index, and p53 had no prognostic value. Multivariate modeling demonstrated that age, gender, and Ki-67 were the strongest factors associated with survival. The relevant literature is reviewed.
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Affiliation(s)
- J F Reavey-Cantwell
- Hunterian Neurosurgical Laboratory, Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
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Mastronardi L, Guiducci A, Buttaro FM, Cristallini EG, Puzzilli F, Maira G. Relationships among DNA Index, S-Phase, and invasive behavior in anterior pituitary adenomas. A cytometric study of 61 cases with Feulgen-positive DNA analysis. SURGICAL NEUROLOGY 2001; 56:27-32. [PMID: 11546567 DOI: 10.1016/s0090-3019(01)00455-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Pituitary adenomas are usually well differentiated neoplasms, although in about 1/3 of cases they invade the surrounding dura mater and bone, as confirmed by surgical findings, resulting in a long-term possibility of relapse. METHODS To identify the cellular growth rate and to correlate it with surgical evidence of invasiveness, we performed the analysis of DNA with static cytometric quantitation on fresh surgical specimens, using a computer-assisted image processor. The DNA index and the percentage of cells in S-phase (%SPh) were obtained in 61 pituitary tumors consecutively operated on. In relation to surgically verified infiltration of dura and bone, we identified 39 noninvasive and 22 invasive adenomas. The cavernous sinus (CS) was infiltrated in 13 cases. On the basis of immunohistochemical staining and endocrine activity we recognized 27 nonsecreting and 34 secreting adenomas. RESULTS The DNA content was aneuploid in 33 cases (11 nonfunctioning, 22 functioning; p = 0.05); there was no correlation with the invasive behavior of the adenomas. The DNA index ranged between 0.93 and 2.50 (median 1.13); the range of %SPh was 0-12.00% (median 2.54%). In invasive adenomas the mean DNA index was 1.33 (p not significant) and the mean %SPh was 4.03% (p = 0.05). In CS-infiltrating pituitary adenomas, the mean DNA index was 1.44 (p = 0.04) and the mean %SPh was 4.52% (p = 0.05). CONCLUSIONS Our preliminary results seem to reveal a correlation between DNA index, %SPh, and invasive behavior of pituitary adenomas, encouraging the use of DNA analysis in the prognostic evaluation of these tumors.
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Affiliation(s)
- L Mastronardi
- Unit of Neurosurgery, Sandro Pertini Hospital of Rome, Italy
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Zellner A, Meixensberger J, Roggendorf W, Janka M, Hoehn H, Roosen K. DNA ploidy and cell-cycle analysis in intracranial meningiomas and hemangiopericytomas: a study with high-resolution DNA flow cytometry. Int J Cancer 1998; 79:116-20. [PMID: 9583723 DOI: 10.1002/(sici)1097-0215(19980417)79:2<116::aid-ijc3>3.0.co;2-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Although various DNA flow-cytometric studies have been performed on meningiomas, the role of DNA ploidy and the S-phase fraction (SPF) in predicting biological tumor behavior remains unresolved. Discrepant results in earlier studies might be due to different preparing, staining and measuring techniques; different quality standards; and lack of sophisticated computer software. In this study, high-resolution DNA flow cytometry using the DNA-specific dye DAPI (4', 6'-diamidino-2-phenylindol) was performed on stored frozen tissue from 128 microsurgically resected meningiomas and 7 hemangiopericytomas, including 17 recurrent meningiomas and 4 recurrent hemangiopericytomas. The computer software Multicycle 2.5 was used to determine the ploidy level and to perform cell-cycle analysis. DNA aneuploidy and SPF were significantly higher in atypical, anaplastic and recurrent meningiomas and correlated well with histopathological features such as focal necrosis, infiltration of dura mater and mitotic activity. Among 128 meningiomas, 42 had additional DNA aneuploid stem lines. No association between hypo- and hyperploidy and either histological subtype or clinical outcome was found. In 7 hemangiopericytomas, SPF was significantly higher compared to the benign meningioma group, while only 1 tumor was aneuploid. In all 42 DNA aneuploid tumors, cell-cycle analysis was performed separately for the euploid and aneuploid stem lines. The proliferation parameters (SPF, G2/M phase) were significantly higher in the DNA aneuploid stem lines. DNA ploidy and SPF are thus useful indicators of different biological behavior within identical histological subgroups in meningiomas.
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Affiliation(s)
- A Zellner
- Department of Neurology, University of Würzburg, Germany
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9
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Struikmans H, Rutgers DH, Jansen GH, Tulleken CA, van der Tweel I, Battermann JJ. S-phase fraction, 5-bromo-2'-deoxy-uridine labelling index, duration of S-phase, potential doubling time, and DNA index in benign and malignant brain tumors. RADIATION ONCOLOGY INVESTIGATIONS 1997; 5:170-9. [PMID: 9327496 DOI: 10.1002/(sici)1520-6823(1997)5:4<170::aid-roi2>3.0.co;2-v] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Seventy-one histologically malignant brain tumors, 52 histologically benign brain tumors, and 14 cerebral metastases were characterized according to DNA content and proliferative capacity. DNA ploidy, DNA index (DI), S-phase fraction (SPF), 5-bromo-2'-deoxy-uridine (BrdUrd) labelling index (LI), duration of S-phase (Ts), and potential doubling time (Tpot) were assessed by flow cytometry (FCM). In histologically benign tumors, a high percentage of DNA diploid tumors and a low proliferative capacity in DNA diploid tumors were found. Histologically malignant tumors and cerebral metastases were both found to be characterized by a low percentage of DNA diploid tumors and a high proliferative capacity in DNA diploid tumors. The proliferative capacity of DNA aneuploid benign tumors and that of DNA aneuploid malignant tumors, however, appeared not to differ significantly. The number of DNA aneuploid tumors was small. Duration of S-phase was short (range 3.9-4.7 hr) and appeared not to differ between the three groups. From this, the observed differences in Tpot values should be accredited mainly to differences in LI. High-grade as well as low-grade gliomas both appeared to be characterized by malignant (FCM) features, i.e., 1) a high percentage DNA aneuploidy, 2) a high mean DI (for DI > 1), and 3) a high proliferative capacity.
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Affiliation(s)
- H Struikmans
- Department of Radiotherapy, University Hospital, Utrecht, The Netherlands
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Vavruch L, Nordenskjöld B, Carstensen J, Eneström S. DNA ploidy and S-phase in recurrent astrocytomas: a retrospective study by flow cytometry of deparaffinized specimens. J Neurooncol 1996; 30:37-45. [PMID: 8865001 DOI: 10.1007/bf00177441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Twenty-two patients with recurrent astrocytic tumors were treated surgically two or even three times. At the time of the first surgery 6 tumors were fibrillary astrocytomas (grade II), 9 anaplastic astrocytomas (grade III) and 7 glioblastomas (grade IV). Histopathological specimens from second surgery demonstrated in 12 cases signs of higher grades of malignancy. Flow cytometry (FCM) did not reveal any significant changes of S-phase fraction (p = 0.55). This study supports the theory that, given enough time, the histopathology of brain tumors change significantly from more benign forms to more malignant ones. The flow cytometry (FCM) could trace a weak tendency to higher S-phase fractions at the time of the second surgery. No apparent change of ploidy pattern was observed. In spite of the unequivocal histopathological changes of the recurrent astrocytomas the flow cytometry failed to indicate similar changes in terms of ploidy and S-phase fraction parameters.
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Affiliation(s)
- L Vavruch
- Department of Spinal Surgery, University Hospital, Linköping, Sweden
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Gömöri E, Mészáros I, Méhes G, Dóczi T, Pajor L. Cell kinetic analysis in recurrent neuro-epithelial tumours. Acta Neurochir (Wien) 1996; 138:1036-41. [PMID: 8911539 DOI: 10.1007/bf01412305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The biological behaviour of brain tumours is variable. In the majority of cases, recurrence of the tumour is the decisive factor determining the prognosis and individual survival of patients suffering from a neuro-epithelial neoplasm. The time course of recurrences varies significantly according to differences in tumour cell proliferation. In this study, predictive factors concerning the expected prognosis following the resection of neuro-epithelial tumours were investigated with the aim of improving the histological diagnosis. A retrospective analysis of 22 recurrent neuro-epithelial tumours (recurrent tumour group) and 12 neuro-epithelial tumours with a minimum survival rate of 5 years following radical excision (cured tumour group) was performed by means of flow cytometry and immunohistochemistry using the MIB 1 antibody. Histological samples of the subgroups of the recurrent tumour group, i. e., the primary tumours and their recurrences were compared with each other, and the subgroups were compared with the cured tumour group. A multivariate analysis of the data was performed with the BMPD Hotteling T square test. A statistically significant difference was found between the recurrent tumour group (primary tumours + recurrences) and the cured group from every investigated aspect. On the other hand, no difference could be found between the sub-groups primary tumours and their recurrences. All tumours in the recurrent group had an accelerated, active cell cycle, which was expressed in a high proliferation activity. The following conclusion was drawn: an increased risk of recurrence is to be expected in neuro-epithelial tumours characterized by: an S-phase fraction higher than 6-9%, an MIB 1-labelled cell number higher than 2-3/high-power fields, and a number of mitoses higher than 1/10 high-power fields.
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Affiliation(s)
- E Gömöri
- Department of Pathology, University Medical School, Pécs, Hungary
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