Malhan Priya, Husain Nuzhat, Bhalla Shalini, Gupta Rakesh K, Husain Mazhar
Department of Pathology, CSMMU, Lucknow, India.
Indian J Pathol Microbiol. 2010 Jan-Mar;53(1):20-3. doi: 10.4103/0377-4929.59177.
Histological classification and grading are prime procedures in the management of patients with astrocytoma, providing vital data for therapeutic decision making and prognostication. However, it has limitations in assessing biological tumor behavior. This can be overcome by using newer immunohistochemical techniques. This study was carried out to compare proliferative indices using proliferating cell nuclear antigen (PCNA), extent of p53 expression and micro vessel morphometric parameters in patients with low grade and anaplastic astrocytoma. Twenty-five patients, each of grade II and grade III astrocytoma were evaluated using monoclonal antibodies to PCNA, p53 protein and factor VIII related antigen. PCNA, p53-labeling indices were calculated along with micro vessel morphometric analysis using Biovis Image plus Software. Patients with grade III astrocytoma had higher PCNA and p53 labeling indices as compared with grade II astrocytoma (29.14 plus/minus 9.87% vs. 16.84 plus/minus 6.57%, p 0.001; 18.18 plus/minus 6.14% vs. 6.14 plus/minus 7.23%, p 0.001, respectively). Micro vessel percentage area of patients with grade III astrocytoma was also (4.26 plus/minus 3.70 vs. 1.05 plus/minus 0.56, p 0.001), higher along with other micro vessel morphometric parameters. Discordance between histology and one or more IHC parameters was seen in 5/25 (20%) of patients with grade III astrocytoma and 9/25 (36%) of patients with grade II disease. PCNA and p53 labeling indices were positively correlated with Pearson's correlation, p less than 0.001 for both). Increased proliferative fraction, genetic alterations and neovascularization mark biological aggressiveness in astrocytoma. Immunohistochemical evaluation scores over meet the challenge of accurate prognostication of this potentially fatal malignancy.
组织学分类和分级是星形细胞瘤患者治疗管理中的主要程序，可为治疗决策和预后提供重要数据。然而，其在评估肿瘤生物学行为方面存在局限性。这可通过使用更新的免疫组织化学技术来克服。本研究旨在比较低级别和间变性星形细胞瘤患者中使用增殖细胞核抗原（PCNA）的增殖指数、p53表达程度和微血管形态学参数。使用针对PCNA、p53蛋白和因子VIII相关抗原的单克隆抗体对25例II级和III级星形细胞瘤患者进行评估。使用Biovis Image plus软件计算PCNA、p53标记指数并进行微血管形态学分析。与II级星形细胞瘤相比，III级星形细胞瘤患者的PCNA和p53标记指数更高（分别为29.14±9. .87%对16.84±6.57%，p<0.001；18.18±6.14%对6.14±7.23%，p<0.001）。III级星形细胞瘤患者微血管百分比面积也更高（4.26±3.70对1.05±0.56，p<0.001），以及其他微血管形态学参数。在III级星形细胞瘤患者中有5/25（20%）以及II级疾病患者中有9/25（36%）出现组织学与一个或多个免疫组化参数不一致的情况。PCNA和p53标记指数呈正相关（Pearson相关性，两者p均<0.001）。增殖分数增加、基因改变和新生血管形成标志着星形细胞瘤的生物学侵袭性。免疫组织化学评估分数超过了准确预测这种潜在致命恶性肿瘤的挑战。
