P53 and Ki-67 Expression in Primary Pediatric Brain Tumors: Does it Correlate with Presentation, Histological Grade, and Outcome?

CONTEXT

Pediatric brain tumors are a vexing problem for the neurosurgeon due to the fragile patient cohort. We attempt to find parameters which can help us to treat and prognosticate these patients in a better way.

AIMS

This study aims to correlate clinical presentation, outcome, and histological grade with P53 and Ki-67 expression in primary pediatric brain tumors.

SETTING DESIGN

This was a prospective, observational study.

PATIENTS AND METHODS

Forty-seven patients with primary brain tumors in the age group 0-18 years were included in this study. Clinical presentation was noted. Patients were operated, and specimen was sent for histopathological and immunohistochemistry examination for p53 and Ki-67. The WHO classification of 2007 was used to grade the tumors. Follow-up was done at 3 and 6 months with Glasgow outcome score. Expression of p53 and Ki-67 in different tumors was correlated with clinical presentation, tumor grade and outcome.

ANALYSIS METHOD

Statistical Package for Social Science version 17. < 0.05 was considered statistically significant.

RESULTS

There was statistically significant correlation between high tumor grade and high Ki-67 levels ( = 0.000). On post hoc analysis, there was a significant difference between p53 levels in Grade 1 and Grade 4 tumors. There was statistically significant correlation between neurological deficit and higher p53 levels ( = 0.040). There was statistically significant correlation between poor outcome and higher p53 ( = 0.034) and Ki-67 ( = 0.000) levels at 3 months follow-up which continued at 6 months.

CONCLUSIONS

From this study, we conclude that p53 and Ki-67 expression in pediatric brain tumors is associated with poor outcome and correlates with tumor grade. Moreover, p53 expression correlates with neurological deficit.