DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20180317

Clinicohistopathological study of astrocytomas along with Ki-67 proliferative index

Basumitra Das, Kurimella Vamsya Raj, Bhagyalakshmi Atla

Abstract


Background: Astrocytomas form the largest group of gliomas (>75%) and diffusely infiltrating    accounting for more than 60% of all the primary brain tumors. The ki67 proliferative index is a potent biologic marker that estimates the growth of neoplasms quantitatively and thus will aid in identifying the prognosis for patients with neoplasms.  The aim of the research work was to study various histopathological and clinical features of Astrocytomas in detail, to evaluate Ki-67 proliferative index in patients of Astrocytomas and to compare the results of Immunohistochemistry with histological grade of Astrocytomas.

Methods: A   total   number   of    40 cases of   Astrocytomas were included in the study.  Ki-67 immunostaining was done on all cases and compared with WHO histological grading of astrocytomas.

Results: The mean Ki‑67 LI in Grade I astrocytomas was 4.66, range 4-5 ,  in Grade II astrocytomas mean was 8.07, range 5-12 ,in Grade III astrocytomas mean was 13.5 , range 8-20,  in Grade IV astrocytomas mean was 22.93, range 15-50. There was a highly significant correlation between the histopathological grade of astrocytomas and Ki-67 LI (p<0.05).

Conclusions: The monoclonal antibody Ki-67 has proven its prognostic and diagnostic power in astrocytic tumors. Ki-67 LI is the simplest and the most reliable method for evaluating cell proliferation. Ki-67 LI increased with histological grade and the difference between low grade (I and II astrocytomas) and high grade (grade III and IV) is significant. In the present study Ki-67 LI is not dependent on factors like age and sex and is solely dependent on histological grade.


Keywords


Astrocytomas, Ki-67, Labeling index

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References


Mahzouni P, Mokhtari M, Amirmansour B. Differentiation between reactive gliosis and astrocytomas by MIB-1/ki67 immunostaining. JRMS. 2007;12(5):241-245.

Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 2007 Aug;114(2):97-109.

Gerdes J, Becker MH, Key G, Cattoretti G. Immunohistological detection of tumor growth fraction (Ki-67 antigen) in formalin-fixed and routinely processed tissues. J Pathol. 1992;168:85-6.

Wakimoto H, Aoyagi M, Nakayama T, Nagashima G, Yamamoto S, Tamaki M, et al. Prognostic significance of Ki‑67 labeling indices obtained using MIB‑1 monoclonal antibody in patients with supratentorial astrocytomas. Cancer. 1996;77:373‑80.

Gözü H, Bilgiç B, Hazneci J, Sargın H, Erkal F, Sargın M, et al. Is Ki-67 index a useful labeling marker for invasion of pituitary adenomas? Turkish J Endocrinol Metab. 2005;4:107-13.

Habberstad AH, Gulati S, Torp SH. Evaluation of the proliferation markers Ki-67/MIB-1, mitosin, survivin, pHH3, and DNA topoisomerase IIα in human anaplastic astrocytomas: an immunohistochemical study. Diagn Pathol. 2011;6:43

Ganju V, Jenkins RB, O'Fallon JR, Scheithauer BW, Ransom DT, Katzmann JA et al. Prognostic factors in gliomas. A multivariate analysis of clinical, pathologic, flow cytometric, cytogenetic, and molecular markers. Cancer. 1994 Aug;74(3):920-7..

Thotakura M, Tirumalasetti N, Krishna R. Role of Ki-67 labeling index as an adjunct to the histopathological diagnosis and grading of astrocytomas. Journal Cancer Res Therapeu. 2014 Jul;10(3):641.

Katsetos CD, Del Valle L, Geddes JF, Assimakopoulou M, Legido A, Boyd JC et al. Aberrant localization of the neuronal class III β-tubulin in astrocytomas: A marker for anaplastic potential. Arch Pathol Lab Med. 2001 May;125(5):613-24.

Cohadon F, Aouad N, Rougier A, Vital C, Rivel J, Dartigues JF. Histologic and non –histologic factors correlated with survival time in supratentorial astrocytic tumors. J Neurooncol. 1985;3:105-11.

Ambroise MM, Khosla C, Ghosh M, Mallikarjuna VS, Annapurneswari S. Practical value of MIB‑1 index in predicting behavior of astrocytomas. Indian J Pathol Microbiol. 2011;54:520‑5.

Montine TJ, Vandersteenhoven JJ, Aguzzi A, Boyko OB, Dodge RK, Kerns BJ, et al. Prognostic significance of Ki‑67 proliferation index in supratentorial fibrillary astrocytic neoplasms. Neurosurgery. 1994;34:674‑8.

Rathi KR, Radotra BD, Khosla VK. Proliferative index in astrocytic tumours. Indian J Pathol Microbiol. 2007;50:754‑8.

Klein R, Roggendorf W. Increased microglia proliferation separates pilocytic astrocytomas from diffuse astrocytomas: A double labeling study. Acta Neuropathol. 2001;101:245‑8.

Giannini C, Scheithauer BW, Burger PC, Christensen MR, Wollan PC, Sebo TJ et al. Cellular proliferation in pilocytic and diffuse astrocytomas. J Neuropathol Exp Neurol. 1999;58:46-53.

Ralte AM, Sharma MC, Karak AK, Mehta VS, Sarkar C. Clinicopathological features, MIB‑1 labeling index and apoptotic index in recurrent astrocytic tumors. Pathol Oncol Res. 2001;7:267‑78.

Hsu DW, Louis DN, Efird JT, Hedley-Whyte ET. Use of MIB-1(Ki-67) immunoreactivity in differentiating grade II and grade III Gliomas. J Neuropathol Exp Neurol. 1997;56:857-65.

Avninder S, Sharma MC, Deb P, Mehta VS, Karak AK, Mahapatra AK, et al. Gemistocytic astrocytomas: Histomorphology, proliferative potential and genetic alterations-a study of 32 cases. J Neurooncol. 2006;78:123-7.

Eneström S, Vavruch L, Frånlund B, Nordenskjöld B. Ki-67 antigen expression as a prognostic factor in primary and recurrent astrocytomas. Neurochir. 1998 Mar;44(1):25-30.

Jaros E, Perry RH, Adam L, Kelly PJ, Crawford PJ, Kalbag RM, et al. Prognostic implication of p53 protein, epidermal growth factor receptor and Ki-67 labelling in brain tumor. Br J Cancer. 1992;66:373-85.

Neder L, Colli BO, Machado HR, Carlotti CG Jr, Santos AC, Chimelli L. MIB-1 labeling index in astrocytic tumors-a clinicopathologic study. Clin Neuropathol. 2004;23:262-70.

Rodriguez-Pereira C, Suárez-Penaranda JM, Vázquez-Salvado M, Sobrido MJ, Abraldes M, Barros F et al. Value of MIB-1 labelling index (LI) in gliomas and its correlation with other prognostic factors. J Neurosurg Sci. 2000;44:203-10.

McKeever PE, Ross DA, Strawderman MS, Brunberg JA, Greenberg HS, Junck L. A comparison of the predictive power for survival in gliomas provided by MIB-1, bromodeoxyuridine and proliferating cell nuclear antigen with histopathologic and clinical parameters. J Neuropathol Exp Neurol. 1997;56:798-805.

Ellison DW, Steart PV, Bateman AC, Pickering RM, Palmer JD, Weller RO. Prognostic indicators in a range of astrocytic tumours: An immunohistochemical study with Ki-67 and p53 antibodies. J Neurol Neurosurg Psychiatr. 1995;59:413-9.

Ribeiro Mde C, Coutinho LM, Hilbig A. The role of apoptosis, cell proliferation index, bcl-2, and p53 in glioblastoma prognosis. Arq Neuropsiquiatr. 2004;62:262-70.

Bouvier-Labit C, Chinot O, Ochi C, Gambarelli D, Dufour H, FigarellaBranger D. Prognostic significance of Ki67, p53 and epidermal growth factor receptor immunostaining in human glioblastomas. Neuropathol Appl Neurobiol. 1998;24:381-8.

Moskowitz SI, Jin T, Prayson RA. Role of MIB1 in predicting survival in patients with glioblastomas. J Neurooncol. 2006;76:193-200.

Roessler K, Bertalanffy A, Jezan H, Ba-Ssalamah A, Slavc I, Czech T, et al. Proliferative activity as measured by MIB-1 labeling index and long-term outcome of cerebellar juvenile pilocytic astrocytomas. J Neurooncol. 2002;58:141-6.

Grzybicki DM, Liu Y, Moore SA, Brown HG, Silverman JF, D’Amico F et al. Interobserver Variability Associated with the MIB-1Labeling Index. Cancer. 2001;92:2720-6.