National Cancer Institute®
Last Modified: June 1, 2002
UI - 11912469
AU - Mastronardi L; Guiducci A; Puzzilli F
TI - Proposal of a clinico-histological "glioma score" as a prognostic index in high-grade glioma patients. Preliminary observations in a series of 80 cases.
SO - J Neurosurg Sci 2001 Dec;45(4):195-201; discussion 201
AD - Division of Neurosurgery, Sandro Pertini Hospital, Rome, Italy. firstname.lastname@example.org
BACKGROUND: Despite of several multimodal treatments, malignant gliomas still have a poor outcome. In order to identify subgroups of patients with different prognosis, we propose a clinical and histological score (GS). METHODS: Eighty consecutive patients operated on for a high-grade glioma and treated with adjuvant therapy entered the study. In relation to age at diagnosis, preoperative Karnofsky Performance Status (KPS), and MIB-1 index, patients have been splitted in 4 groups (GS 0-III). RESULTS: The overall mean survival of the entire cohort was 18.2 months (median 12). Patients with GS 0 have a mean survival rate of 30.0 months, with GS I 23.1 months, with GS II 12.1 months, and with GS III 9.0 months (p=0.0001). Moreover, mean survival with a KPS = or >70 was 29.0 in GS 0, 26.0 in GS I, 10.0 in GS II, and 0 in GS III patients (p<0.0001). CONCLUSIONS: On the basis of these preliminary observations, we discuss the utility of our "glioma score" as a prognostic indicator for patients operated on for cerebral malignant gliomas and treated postoperatively with adjuvant therapy.
UI - 11935241
AU - Cho KT; Wang KC; Kim SK; Shin SH; Chi JG; Cho BK
TI - Pediatric brain tumors: statistics of SNUH, Korea (1959-2000).
SO - Childs Nerv Syst 2002 Feb;18(1-2):30-7
AD - Division of Pediatric Neurosurgery and Clinical Research Institute, Seoul National University Children's Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea. email@example.com
OBJECTIVE: To investigate the age, gender, location and pathologic diagnosis of brain tumors in pediatric patients (less than 16 years old), we reviewed 677 patients who were operated on at the Department of Neurosurgery, Seoul National University Hospital (SNUH) during the for which pathologic specimens were available were included. Tumors of bone origin, purely extradural mass, nontumorous cystic lesions, and vascular malformations were excluded. The mean age of the 677 patients was 7.8 years and the gender ratio (male-to-female ratio), 1.4:1. Supratentorial tumors (60.0%) were more common than infratentorial tumors (39.1%). Pathological examination showed that the most common tumors were astrocytic tumors (25.7%), medulloblastomas (17.9%), craniopharyngiomas (12.0%), germ cell tumors (11.2%), supratentorial primitive neuroectodermal tumors (ST-PNETs) (5.5%), and neuronal tumors (5.2%). Choroid plexus tumors and ependymal tumors occurred more frequently in early childhood, while pituitary adenomas and non-teratomatous germ cell tumors occurred more frequently in older children. While most tumors were more predominant in males, oligodendroglial tumors and pituitary adenomas were more predominant in females. CONCLUSIONS: The relative incidences of germ cell tumors, neuronal tumors, and oligodendroglial tumors increased after the introduction of magnetic resonance imaging (MRI). In contrast, the incidence rates of medulloblastomas and ependymal tumors decreased.
UI - 11436884
AU - Simanovsky N; Taylor GA
TI - Sonography of brain tumors in infants and young children.
SO - Pediatr Radiol 2001 Jun;31(6):392-8
AD - Department of Radiology, Children's Hospital and Harvard Medical School, Boston, MA 02115, USA. firstname.lastname@example.org
The sonographic features of five brain tumors are presented to emphasize the variability of imaging findings and the role that sonography may play in the initial diagnosis, determination of tumor vascularity, and biopsy guidance.
UI - 11930044
AU - Cha S; Knopp EA; Johnson G; Wetzel SG; Litt AW; Zagzag D
TI - Intracranial mass lesions: dynamic contrast-enhanced susceptibility-weighted echo-planar perfusion MR imaging.
SO - Radiology 2002 Apr;223(1):11-29
AD - Department of Radiology, New York University Medical Center, 530 First Ave, HCC-Basement, MRI Center, New York, NY 10016, USA.
Dynamic contrast agent-enhanced perfusion magnetic resonance (MR) imaging provides physiologic information that complements the anatomic information available with conventional MR imaging. Analysis of dynamic data from perfusion MR imaging, based on tracer kinetic theory, yields quantitative estimates of cerebral blood volume that reflect the underlying microvasculature and angiogenesis. Perfusion MR imaging is a fast and robust imaging technique that is increasingly used as a research tool to help evaluate and understand intracranial disease processes and as a clinical tool to help diagnose, manage, and understand intracranial mass lesions. With the increasing number of applications of perfusion MR imaging, it is important to understand the principles underlying the technique. In this review, the essential underlying physics and methods of dynamic contrast-enhanced susceptibility-weighted echo-planar perfusion MR imaging are described. The clinical applications of cerebral blood volume maps obtained with perfusion MR imaging in the differential diagnosis of intracranial mass lesions, as well as the pitfalls and limitations of the technique, are discussed. Emphasis is on the clinical role of perfusion MR imaging in providing insight into the underlying pathophysiology of cerebral microcirculation.
UI - 11783910
AU - Biernat W; Liberski PP; Kordek R; Zakrzewski K; Polis L; Budka H
TI - Dysembryoplastic neuroectodermal tumor: an ultrastructural study of six cases.
SO - Ultrastruct Pathol 2001 Nov-Dec;25(6):455-67
AD - Department of Tumor Pathology, Medical Academy Lodz, Poland.
Dysembryoplastic neuroectodermal tumor (DNT) is a rare brain neoplasm. Although the tumor pathology is relatively well charactererized, its full clinicopathological spectrum is still discussed, and ultrastructural data on it are very limited. Here, the authors describe detailed ultrastructural pathology of 7 cases of DNT. Each tumor consisted of 3 major elements: neoplastic cells (oligodendroglial-like cells, OLC), elongated processes forming neuropil-like structure, and expanded "mucoid" extracellular space, the latter giving an impression of cellular elements floating within it. Neoplastic cells had round, oval, or elongated nuclei, no discernible nucleoli, and a relatively narrow rim of cytoplasm. Some nuclei were irregular and invaginated, and pseudoinclusions (invaginations of cytoplasm penetrated into toroid-like nuclear formations) were observed. Part of the cytoplasm sequestrated within pseudoinclusions often appeared degenerated with large blebs and electron-lucent vesicles, and some of these contained, in turn, semicircular profiles of unknown significance. Chromatin was clustered below the nuclear membrane. The cytoplasm contained a few mitochondria, round rather than elongated, a few stacks of rough endoplasmic reticulum, and scanty microtubules and clear vesicles. The second element consisted of innumerable cellular processes. Some of these were elongated and formed stacks connected by symmetric or asymetric adhesive plaque junctions. Others had shorter "neck" containing microtubules extending into bulbous extensions. Dense-cored vesicles were occasionally observed, both in the cytoplasm of neoplastic cells and within processes. In one cell, cross-sectioned annulate lamellae were found. In the cytoplasm of a few cells, unusual inclusions reminiscent of ribosome-lamellae resembled "laboratory tubes" with cone-like endings. At higher power, walls of the "tubes" resolved into layered structures composed of several laminae; between these, ribosome-like structures were visible. The authors conclude that OLC exhibit clear-cut characteristics of neuronal cells and not true oligodendocytes.
UI - 11783911
AU - Hirose T; Giannini C; Scheithauer BW
TI - Ultrastructural features of pleomorphic xanthoastrocytoma: a comparative study with glioblastoma multiforme.
SO - Ultrastruct Pathol 2001 Nov-Dec;25(6):469-78
AD - Department of Pathology, Saitama Medical School, Japan.
Eighteen tumors (15 cases) were ultrastructurally examined and compared to 11 examples of glioblastoma multiforme (GBM) [to determine the cellular nature of pleomorphic xanthoastrocytoma (PXA).] PXA, as well as GBM, were principally composed of pleomorphic astrocytes containing numerous intermediate filaments. Lipid droplets, lysosomes, and basal laminas were more numerous and fully developed in PXA, but were not specific to the tumor. Aggregates of secondary lysosomes, light microscopically evident as eosinophilic granular bodies, and ribosome-lamella complexes were exclusively seen in PXA. Also noted in PXA were centrioles, occasional Rosenthal fibers, hemidesmosomes in small number, rudimentary cell junctions, and interstitial calcifications. In addition to astrocytic constituents, 20% of PXA contained cells with neuronal features, as evidenced by the presence of dense-core granules, microtubules, and clear vesicles. In contrast, GBMs consisted solely of astrocytic cells. In the present study, the salient ultrastructural findings of PXA were largely degenerative in nature, including numerous lipid droplets and secondary lysosomes, as well as basal laminas, ribosome-lamella complexes, and occasional neuronal differentiation. The presence of basal lamina does not necessarily imply a histogenetic derivation from subpial astrocytes, in that it is also a common feature of GBM. Given the occurrence of biphenotypic, glioneuronal differentiation in some cases, PXA may be derived from a neuroepithelial stem cell. The authors conclude that PXA is fundamentally an astrocytic tumor, albeit one with a significant tendency to undergo neuronal differentiation.
UI - 11980090
AU - Ryuke Y; Mizuno M; Natsume A; Yoshida J
TI - Transduction efficiency of adenoviral vectors into human glioma cells increased by association with cationic liposomes.
SO - Neurol Med Chir (Tokyo) 2000 May;40(5):256-60
AD - Department of Neurosurgery, Nagoya University School of Medicine, Nagoya.
Replication-deficient adenoviral vectors are promising agents for human gene therapy of the greater transduction efficiency than other vectors. However, there are distinct disadvantages, including high immunogenicity, which limits the administration to human organs, particularly the brain. Injection of adenoviral vectors into the human brain causes inflammatory responses and induces cerebral edema. The combined effect of adenoviral vectors and cationic liposomes in vitro was investigated in an effort to reduce the immune reaction against the antigens of adenoviral vectors. No toxicity of adenoviral vector-associated liposomes was observed within optimal lipid concentration. The transduction efficiency of the adenoviral vectors containing the beta-galactosidase gene increased almost 10-fold when associated with the cationic liposomes. Furthermore, greater cytotoxicity was induced when the adenoviral vector containing herpes simplex virus-thymidine kinase gene was combined with cationic liposomes than with only the adenoviral vector. These results suggest that the combination of adenoviral vectors and cationic liposomes allows the doses of adenoviral vectors to be reduced while maintaining transduction efficiency.
UI - 11894972
AU - Erfurth EM; Bulow B; Mikoczy Z; Svahn-Tapper G; Hagmar L
TI - Is there an increase in second brain tumours after surgery and irradiation for a pituitary tumour?
SO - Clin Endocrinol (Oxf) 2001 Nov;55(5):613-6
AD - Department of Internal Medicine, University Hospital, Lund, Sweden. Eva-Marie.Erfurth@med.lu.se
OBJECTIVE: To assess the incidence of second brain tumours in patients operated and irradiated for pituitary tumours. DESIGN AND PATIENTS: The study base consisted of a consecutive series of 325 patients operated and irradiated for pituitary tumours, excluding patients with acromegaly and Cushing's disease. Comparison was made with the general population from the same catchment area as the patients. The follow-up period started in 1958 and on an individual basis patients were followed from date of death, emigration or a second brain tumour diagnosis, whichever occurred first. RESULTS: Three brain tumours (two astrocytomas and one meningioma) were observed, compared with 1-13 expected (standardized incidence ratios (SIR) 2.7; 95% confidence interval (CI) 0.6-7.8). CONCLUSION: The present study gives no firm support for an increased incidence of a second brain tumour in patients operated and irradiated for pituitary tumours. A crude meta-analysis of the present and previously published cohort studies of patients with irradiated pituitary tumours gives an SIR of 6.1 (95% CI 3.16-10.69). Thus, the results of the meta-analysis are in favour of an increased risk for second brain tumours. A genetic trait that predisposes to both pituitary tumours and brain tumours is an alternative causal factor. There is no definite proof that cranial irradiation per se is the causal factor. This question cannot be fully answered until sufficient cohort studies of nonirradiated pituitary tumour patients have been carried out.
UI - 11987617
AU - Liberski PP; Fiks T
TI - [Gangliocytoma, ganglioglioma and anaplastic oligodendroglioma]
SO - Pol J Pathol 2001;52(4 Suppl):71-85
AD - Zaklad Biologii Molekularnej, Katedra Onkologii AM, lodz.
UI - 11987619
AU - Kordek R; Liberski PP
TI - [Infantile desmoplastic ganglioglioma and desmoplastic cerebral astrocytoma of infancy]
SO - Pol J Pathol 2001;52(4 Suppl):95-8
AD - Zaklad Patologii Nowotworow, Katedra Onkologii AM, lodz.
UI - 11814473
AU - Basu PS; Majhi R; Ghosh S; Ghosh B; Batabyal SK
TI - Immunodiagnosis of the primary brain tumor (glioma) by the endogenous lectin.
SO - Clin Chim Acta 2002 Mar;317(1-2):177-80
AD - Indian Institute of Chemical Biology, 4, Raja S.C. Mallick Road, 700 032, Calcutta, India. email@example.com
BACKGROUND: A sugar-binding protein, lectin, was identified in the cystic fluid of brain tumor (glioma). METHODS: The protein was purified by high performance liquid chromatography. RESULTS: The molecular weight of the lectin was 29 kDa. The activity of the purified protein was inhibited strongly by p-nitro-beta-D-galactose and asialofetuin. The lectin activity was not Ca(2+)- or Mg(2+)-dependent. The antiserum of this pure lectin specifically cross-reacted in the cerebrospinal fluid (CSF) of glioma tumor patients. The same antibody had no reaction with CSF of other neurological patients, normal rat brain tissue extract, oncofetal antigens such as alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), plant lectins, and other body fluids like plural and ascites. CONCLUSIONS: This antilectin antibody may be useful in the evaluation of patients with primary brain tumor (glioma).
UI - 12025942
AU - Gomori E; Fulop Z; Meszaros I; Doczi T; Matolcsy A
TI - Microsatellite analysis of primary and recurrent glial tumors suggests different modalities of clonal evolution of tumor cells.
SO - J Neuropathol Exp Neurol 2002 May;61(5):396-402
AD - Department of Pathology, Faculty of Medicine, Pecs University, Hungary.
Gliomas are characterized by highly variable biological behavior. After surgical resection and postoperative therapy they frequently recur with the same or higher-grade histology. Although a number of genetic aberrations have been described in gliomas of different histological types, the molecular mechanisms of the histological and clinical progression are poorly understood. In this study, we performed longitudinal microsatellite and mismatch repair gene analysis in paired samples of primary and recurrent gliomas in order to reveal whether genetic instability is associated with tumor progression. The 7 microsatellite loci of the 7 patients displayed a total of 18 (54.5%) alterations in the primary and 15 (45.5%) alterations in the recurrent gliomas as compared with the corresponding non-neoplastic cells, but no alterations were found in the hMLH1 and hMSH2 genes. These results suggest that microsatellite instability is associated with the development of the primary gliomas rather than with the recurrence or progression, and it is not associated with structural alterations in the hMLH1 or hMSH2 genes. Comparison of the microsatellite patterns in primary and secondary gliomas revealed 4 different modalities of clonal evolution, involving clonal identity, clonal deletion, clonal progression, and different clonality, suggesting that intensive clonal selection may play a central part in the recurrence of gliomas.
UI - 12025943
AU - Suzuki SO; Kitai R; Llena J; Lee SC; Goldman JE; Shafit-Zagardo B
TI - MAP-2e, a novel MAP-2 isoform, is expressed in gliomas and delineates tumor architecture and patterns of infiltration.
SO - J Neuropathol Exp Neurol 2002 May;61(5):403-12
AD - Division of Neuropathology, Columbia University College of P&S, New York, New York, USA.
The MAP-2 isoform containing exon 13 (MAP-2e) is expressed in human fetal development as early as 15 gestational weeks and parallels oligodendrocyte maturation. MAP-2e is down-regulated following myelination and is expressed in few cells in the adult central nervous system (CNS). To determine whether CNS tumors express MAP-2e, we screened 122 archival, paraffin-embedded adult and pediatric tumors of the CNS and non-CNS. All oligodendrogliomas were positive and extensive staining was observed in glioblastomas, various malignant gliomas and dysembryoplastic neuroepithelial tumors. MAP-2e was not expressed in non-CNS tumors or neuroblastomas. Thus. neuroectodermal tumors that have glial characteristics express this developmental marker of immature glia. Analysis of oligodendrogliomas demonstrated numerous cell morphologies from round cells with no processes to cells with single or multiple processes. MAP-2e immunostaining also delineated tumor invasion into adjacent gray and white matter, indicating that MAP-2e appears to be a useful marker for examining the infiltration of malignant cells into surrounding tissue.
UI - 11948632
AU - Yakut T; Bekar A; Doygun M; Acar H; Egeli U; Ogul E
TI - Evaluation of relationship between chromosome 22 and p53 gene alterations and the subtype of meningiomas by the interphase-FISH technique.
SO - Teratog Carcinog Mutagen 2002;22(3):217-25
AD - Department of Medical Biology and Genetics, Faculty of Medicine, University of Uludag, Bursa, Turkey.
In this study, we investigated the relationship between genetic alterations such as chromosome 22 aneuploidy and p53 gene deletion, and the pathological types of meningioma of typical and aggressive forms. Thirty-four meningiomas (23 typical and 11 aggressive) were examined by application of fluorescence in situ hybridization (FISH) with chromosome 22 specific alpha satellite probe and a combination of p53 locus specific and chromosome 17 centromere specific alpha satellite probes, to evaluate the chromosome 22 aneuploidy and gain or loss of p53 gene along with chromosome 17. The results showed that, although chromosome 22 aneuploidy was seen in 7 out of 23 typical (30.4%) and 4 out of 11 aggressive meningiomas (36.3%), no p53 deletion was detected in typical meningiomas, and p53 deletion was detected in 3 out of 11 aggressive meningiomas (1 atypical and 2 malignant), which had recurrence. There were no simultaneous occurrences of p53 gene deletions between typical and aggressive meningiomas. The present findings indicate that the loss of chromosome 22 may be involved with tumorogenesis of typical and aggressive meningiomas, while p53 gene deletions may be involved with malignant progression and recurrence in the aggressive meningiomas. Copyright 2002 Wiley-Liss, Inc.
UI - 11939587
AU - Schmidt MC; Antweiler S; Urban N; Mueller W; Kuklik A; Meyer-Puttlitz B;
TI - Wiestler OD; Louis DN; Fimmers R; von Deimling A Impact of genotype and morphology on the prognosis of glioblastoma.
SO - J Neuropathol Exp Neurol 2002 Apr;61(4):321-8
AD - Department of Neurosurgery, University of Bonn Medical Center, Germany.
The recognition of molecular subsets among glioblastomas has raised the question whether distinct mutations in glioblastoma-associated genes may serve as prognostic markers. The present study on glioblastomas (GBM) from 97 consecutively sampled adult patients is based on a clinical, histopathological, immunohistochemical, and molecular genetic analysis. Parameters assessed were age at diagnosis, survival, cell type, proliferation, necrosis, microvascular proliferation, sarcomatous growth, lymphocytic infiltration, thromboses, calcifications, GFAP expression, MIB-1 index, loss of heterozygosity (LOH) of the chromosomal arms 1p, 10p, 10q, 17p, 19q and structural alterations in the TP53, EGFR and PTEN genes. As in previous studies, younger age was significantly associated with better survival. Among the molecular parameters, TP53 mutations and LOH10q emerged as favorable and poor prognostic factors, respectively. TP53 mutations were a favorable prognostic factor independent of whether glioblastomas were primary or secondary. LOH1p or 19q, lesions suspected to be over-represented in long term survivors with malignant glioma, were not associated with better survival. However, the combination of LOH1p and LOH19q defined GBM patients with a significantly better survival. Notably, these patients did not exhibit morphological features reminiscent of oligodendroglioma. These findings indicate that genotyping of glioblastoma may provide clinical information of prognostic importance.
UI - 12002035
AU - Nano R
TI - Experimental findings in primary glioma cell cultures.
SO - Funct Neurol 2001;16 Suppl 4():285-9
AD - Department of Animal Biology, University of Pavia and Centre of Study for Histochemistry, CNR, Italy. firstname.lastname@example.org
UI - 12001139
AU - Vordermark D
TI - Expression of hypoxia-inducible factor-1alpha in oligodendrogliomas: its impact on prognosis and on neoangiogenesis.
SO - Cancer 2002 Apr 15;94(8):2317-8; discussion 2318-9
UI - 11979441
AU - Brenner AV; Linet MS; Fine HA; Shapiro WR; Selker RG; Black PM; Inskip
TI - PD History of allergies and autoimmune diseases and risk of brain tumors in adults.
SO - Int J Cancer 2002 May 10;99(2):252-9
AD - Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7362, USA. email@example.com
To explore a possible influence of the immune system in the development of brain tumors, we evaluated the relationship between history of allergies and autoimmune diseases and risk of brain tumors within a large, hospital-based case-control study. Cases (n = 782) were patients recently diagnosed with glioma (n = 489), meningioma (n = 197) or acoustic neuroma (n = 96) at hospitals in Boston, Phoenix and Pittsburgh (USA). Controls (n =799) were patients hospitalized for a variety of nonmalignant conditions and frequency-matched to cases by hospital, age, sex, race/ethnicity and distance of residence from hospital. Research nurses collected data by personal interview of patients. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression. There was a significant inverse association between glioma and history of any allergies (OR = 0.67, 95% CI = 0.52-0.86) or autoimmune diseases (OR = 0.49, 95% CI = 0.35-0.69). No significant associations were evident for meningioma or acoustic neuroma with history of any allergies. An inverse association was observed between meningioma and history of autoimmune diseases (OR = 0.59, 95% CI = 0.38-0.92). There was a suggestion of interaction between allergies and autoimmune diseases on risk of glioma (p = 0.06), with subjects having both conditions being at lowest risk (OR = 0.24, 95% CI = 0.14-0.42). Among the specific conditions, asthma and diabetes showed the most consistent associations (OR = 0.63, 95% CI = 0.43-0.92 and OR = 0.44, 95% CI = 0.27-0.70, respectively). Our results add to evidence that persons with allergies or autoimmune diseases are at reduced risk of glioma. The basis of the associations is not clear, but they might imply a role of immunologic factors in the development of brain tumors. Published 2002 Wiley-Liss, Inc.
UI - 12023579
AU - Brat DJ; Scheithauer BW; Medina-Flores R; Rosenblum MK; Burger PC
TI - Infiltrative astrocytomas with granular cell features (granular cell astrocytomas): a study of histopathologic features, grading, and outcome.
SO - Am J Surg Pathol 2002 Jun;26(6):750-7
AD - Department of Pathology, Emory University School of Medicine, Atlanta, Georgia 30322, USA. firstname.lastname@example.org
Granular cell astrocytomas (GCAs) are rare, incompletely characterized infiltrative gliomas that contain a prominent component of granular cells. Such tumors can readily be mistaken for reactive conditions. We studied 22 cases to explore their morphologic spectrum, establish features useful in distinguishing GCA from nonneoplastic diseases, and to determine which parameters correlate with biologic behavior. Tumors occurred in 17 men and five women, ranging in age from 29 to 75 years, who presented mainly with seizures, headache, aphasia, or hemiparesis. Radiologically, high-grade GCAs were contrast-enhancing, cerebral hemispheric masses with prominent peritumoral edema. All contained sheets or interspersed large, round cells packed with eosinophilic, PAS-positive granules. Lymphocytic infiltrates, either perivascular or admixed with neoplastic cells, were present in 14 tumors. Transition to typical infiltrating astrocytoma was noted in 16 cases; of these, granular cells comprised 30-95% of cells. Six tumors consisted almost entirely of atypical granular cells. By WHO criteria, four GCA were grade 2, seven were grade 3, and 11 were grade 4. Glial fibrillary acidic protein staining was seen in all but one tumor, and the majority were immunoreactive for S-100 protein, KP-1, ubiquitin, and epithelial membrane antigen. Although MIB-1 proliferation indices increased with tumor grade, granular cells accounted for only a minority of immunoreactive cells. Among 18 cases with follow-up, 15 recurred after surgery and resulted in death (mean survival, 7.6 months). Two patients died postoperatively, and one was alive at 51 months. Granular cell astrocytoma is an uncommon morphologic variant that appears to be rapidly progressive and usually fatal.
UI - 11702862
AU - De Witte O; Goldberg I; Wikler D; Rorive S; Damhaut P; Monclus M; Salmon
TI - I; Brotchi J; Goldman S Positron emission tomography with injection of methionine as a prognostic factor in glioma.
SO - J Neurosurg 2001 Nov;95(5):746-50
AD - Department of Neurosurgery, Hopital Erasme, Universite Libre de Bruxelles, Brussels, Belgium. email@example.com
OBJECT: Positron emission tomography with L-[methyl-11C]methionine (MET-PET) provides information on the metabolism of gliomas. The aim of this study was to determine the predictive value of MET-PET in the treatment of patients with gliomas. METHODS: Since 1992, 85 patients with a World Health Organization (WHO) classification-verified glioma underwent PET studies in which MET was injected before (74 cases) or after treatment (11 cases). Analysis of PET data was conducted by the same investigator using two scales: a qualitative visual grading scale and a quantitative scale (ratio between tumor uptake and normal brain uptake, classified on a seven-level scale). Uptake of MET was present in 98% of gliomas. The investigator judged this uptake to be moderate to very high based on visual inspection (qualitative scale). For all grades of gliomas, a visual grade of 3 was statistically associated with a shorter patient survival period (p < 0.005). The tumor/normal brain uptake ratio was significantly influenced by the histological grade of the tumor. A statistically poor outcome was demonstrated when this ratio was higher than a threshold of 2.2 for a WHO Grade II tumor and 2.8 for WHO Grade III tumor. For Grade II and III tumors, oligodendrogliomas had a higher uptake of MET than astrocytomas. CONCLUSIONS: Uptake of MET was present in 98% of the gliomas studied. A high uptake is statistically associated with a poor survival time. The intensity of MET uptake represents a prognostic factor for WHO Grade II and III tumors considered separately.
UI - 11702869
AU - Sainte-Rose C; Cinalli G; Roux FE; Maixner R; Chumas PD; Mansour M;
TI - Carpentier A; Bourgeois M; Zerah M; Pierre-Kahn A; Renier D Management of hydrocephalus in pediatric patients with posterior fossa tumors: the role of endoscopic third ventriculostomy.
SO - J Neurosurg 2001 Nov;95(5):791-7
AD - Service de Neurochirurgie, Hopital Necker-Enfants Malades, Paris, France. firstname.lastname@example.org
OBJECT: The authors undertook a study to evaluate the effectiveness of endoscopic third ventriculostomy in the management of hydrocephalus before and after surgical intervention for posterior fossa tumors in children. METHODS: Between October 1, 1993, and December 31, 1997, a total of 206 consecutive children with posterior fossa tumors underwent surgery at Hjpital Necker-Enfants Malades in Paris. Excluded were 10 patients in whom shunts had been placed at the referring hospital. The medical records and neuroimaging studies of the remaining 196 patients were reviewed and categorized into three groups: Group A, 67 patients with hydrocephalus present on admission in whom endoscopic third ventriculostomy was performed prior to tumor removal; Group B, 82 patients with hydrocephalus who did not undergo preliminary third ventriculostomy but instead received conventional treatment; and Group C, 47 patients in whom no ventricular dilation was present on admission. There were no significant differences between patients in Group A or B with respect to the following variables: age at presentation, evidence of metastatic disease, extent of tumor resection, or follow-up duration. In patients in Group A, however, more severe hydrocephalus was demonstrated (p < 0.01): the patients in Group C were in this respect different from those in the other two groups. Ultimately, there were only four patients (6%) in Group A compared with 22 patients (26.8%) in Group B (p = 0.001) in whom progressive hydrocephalus required treatment following removal of the posterior fossa tumor. Sixteen patients (20%) in Group B underwent insertion of a ventriculoperitoneal shunt, which is similar to the incidence reported in the literature and significantly different from that demonstrated in Group A (p < 0.016). The other six patients (7.3%) were treated by endoscopic third ventriculostomy after tumor resection. In Group C, two patients (4.3%) with postoperative hydrocephalus underwent endoscopic third ventriculostomy. In three patients who required placement of CSF shunts several episodes of shunt malfunction occurred that were ultimately managed by endoscopic third ventriculostomy and definitive removal of the shunt. There were no deaths; however, there were four cases of transient morbidity associated with third ventriculostomy. CONCLUSIONS: Third ventriculostomy is feasible even in the presence of posterior fossa tumors (including brainstem tumors). When performed prior to posterior fossa surgery, it significantly reduces the incidence of postoperative hydrocephalus. The procedure provides a valid alternative to placement of a permanent shunt in cases in which hydrocephalus develops following posterior fossa surgery, and it may negate the need for the shunt in cases in which the shunt malfunctions. Furthermore, in patients in whom CSF has caused spread of the tumor at presentation, third ventriculostomy allows chemotherapy to be undertaken prior to tumor excision by controlling hydrocephalus. Although the authors acknowledge that the routine application of third ventriculostomy in selected patients results in a proportion of patients undergoing an "unnecessary" procedure, they believe that because patients' postoperative courses are less complicated and because the incidence of morbidity is low and the success rate is high in those patients with severe hydrocephalus that further investigation of this protocol is warranted.
UI - 11804283
AU - Hayashi Y; Iwato M; Arakawa Y; Fujisawa H; Thoma Y; Hasegawa M;
TI - Tachibana O; Yamashita J Homozygous deletion of INK4a/ARF genes and overexpression of bcl-2 in relation with poor prognosis in immunocompetent patients with primary central nervous system lymphoma of the diffuse large B-cell type.
SO - J Neurooncol 2001 Oct;55(1):51-8
AD - Department of Neurosurgery, Kanazawa University School of Medicine, Japan. email@example.com
Only a few reports have been published on molecular genetic alterations in primary central nervous system lymphomas (PCNSLs) of the diffuse large B-cell type and no reports have addressed the correlation between the genetic alterations and clinical course of the patients with this neoplasm. Thus, the molecular background of the PCNSL and its importance for the clinical course of the patients are still unclear. We investigated a series of 14 patients with PCNSL to determine structural alterations of the INK4a/ARF, MDM2, and TP53 genes, the status of bcl-2 and bcl-6 protein expression, and the clinical course of the patients (i.e. their survival time after diagnosis). No structural alterations of MDM2 and TP53 genes were found. Only INK4a/ARF genes whose expression affects both the p161NK4a-Rb and p14ARF-mdm2-p53 pathways in the regulation for cell cycle and apoptosis, showed an alteration of the homozygous deletions at a high frequency (nine of 14 patients: 64%). This specific alteration was not related with the bcl-6 expression, but a relation was shown with overexpression of the bcl-2 anti-apoptotic protein (p = 0.036, chi-square test), as well as a shorter patient survival (p = 0.044, Wilcoxon test). There was only a tendency, not a significant correlation, in which the patients with bcl-2 overexpression resulted in poor prognosis (p = 0.149). The present study is the first to suggest that the INK4a/ARF gene homozygous deletions and overexpression of the bcl-2 protein may be correlated with each other and together serve as important predictors for the prognosis of patients with PCNSL.
UI - 11927010
AU - Yoshimoto K; Iwaki T; Inamura T; Fukui M; Tahira T; Hayashi K
TI - Multiplexed analysis of post-PCR fluorescence-labeled microsatellite alleles and statistical evaluation of their imbalance in brain tumors.
SO - Jpn J Cancer Res 2002 Mar;93(3):284-90
AD - Division of Genome Analysis, Research Center for Genetic Information, Medical Institute of Bioregulation, Kyushu University, Higashi-ku, Fukuoka 812-8582, Japan.
Detection of the loss of chromosomal regions in cancerous tissues has diagnostic and prognostic relevance, and the development of a reliable and cost-effective technique for this is clinically important. Here we present an efficient technique for quantitative detection of microsatellite alleles, using a post-PCR fluorescence-labeling procedure and multiplexed analysis. We also present a new statistical method for the interpretation of the data that permits reliable and sensitive evaluation of the allelic status of sampled DNA. A high-resolution analysis of allelic imbalance on chromosomes 1p, 10 and 19q in 28 glioma samples of various types using this method revealed that allelic imbalances are more frequent than have been reported, suggesting the diagnostic value of this method in examining the genetic profiles of gliomas.
UI - 11820610
AU - Dzieciol J; Lebelt A; Lemancewicz D; Szkudlarek M; Zimnoch L; Lewko J;
TI - Lebkowski W MIB-I as a proliferative activity marker of the multiform glioblastomas.
SO - Folia Histochem Cytobiol 2001;39 Suppl 2():205-6
AD - Department of Anatomy, Medical Academy of Bialystok, Poland.
MIB-I is a proliferative activity marker of multiform glioblastomas which are the most frequent tumors of the central nervous system. They are characterizad by differential rate and prognosis. The aim of the study was to determine the proliferative activity of multiform glioblastomas and estimation of the correlation between tumors' proliferative activity and tumors' localization, size, patients' age and sex. 24 patients (18 females and 6 males) with multiform glioblastomas were analyzed. The mean patients' age was 52.1. The proliferative activity was calculated as a proliferation index: IP for MIB-I. Cells with positive reaction were determined by MIB-I which was compared to all neoplastic cells. The most frequent localization of the tumors were frontal and temporal lobes of the brain. The size of the tumors ranged from 2.5 to 5.3 cm (mean 3.9). Mean IP was 43.2 (SD+/-17.4). We found no correlation between IP MIB-I and localization of the tumor, patients' age and sex. There was a marginal statistically significant correlation between IP MIB-I and size of the tumor (p=0.005).
UI - 12037678
AU - Mukasa A; Ueki K; Matsumoto S; Tsutsumi S; Nishikawa R; Fujimaki T; Asai
TI - A; Kirino T; Aburatani H Distinction in gene expression profiles of oligodendrogliomas with and without allelic loss of 1p.
SO - Oncogene 2002 Jun 6;21(25):3961-8
AD - Genome Science Division, Research Center for Advanced Science and Technology, University of Tokyo, 4-6-1 Komaba, Meguro-ku 153-8904, Japan.
Oligodendrogliomas frequently, but not always show sensitivity to chemotherapy and recent studies demonstrated that allelic loss of chromosome 1p is highly associated with this chemosensitivity. To gain insight into the molecular mechanism of such difference, we examined comprehensive gene expression profiles of 11 oligodendroglial tumors, six with and five without 1pLOH (loss of heterozygosity), and two normal brain tissues using the oligonucleotide microarray (GeneChip). Statistically significant numbers of genes were expressed differentially between the two genetic subsets. Clustering analysis separated the tumor subsets well. The tumors with 1pLOH had similar expression profiles to the normal brain for those differentially expressed genes. Many genes showing higher expression in tumors with 1pLOH were presumed to have functions in nervous tissues. Notably, the majority of the 123 genes showing significant expression reduction in tumors with 1pLOH were either on chromosome 1 (50%) or on 19 (10%), and the average expression reduction ratio was about 50% (0.54+/-0.13) possibly reflecting the chromosomal deletion. Thus, the biological difference between the genetic subsets of oligodendroglioma was indeed reflected to gene expression profile, which provided baseline information for further studies to elucidate the mechanism of chemosensitivity in gliomas.
UI - 12046728
AU - Dorward NL; Paleologos TS; Alberti O; Thomas DG
TI - The advantages of frameless stereotactic biopsy over frame-based biopsy.
SO - Br J Neurosurg 2002 Apr;16(2):110-8
AD - Department of Neurosurgery, Royal Free Hospital, London, UK. firstname.lastname@example.org
A comparison study is presented, which examines the outcome, complications and cost of stereotactic brain biopsy performed with a frameless versus a frame-based method. The technique of frameless stereotactic biopsy has been shown previously, in both laboratory and in vivo studies, to achieve a level of accuracy at least equal to frame-based biopsy. The investigators have validated the technique in a large clinical series. The frameless and frame-based series were concurrent, comprising 76 and 79 cases, respectively. The frameless stereotactic technique involved standard needle biopsy, targeted by an image-guidance system and directed by a novel rigid adjustable instrument-holder. Frame-based biopsies were performed with the CRW and Leksell systems. There were no significant differences in the demographics, lesion site, size and pathologies between the groups. Operating theatre occupancy and anaesthetic time were both significantly shorter for the frameless series than the frame-based series (p < 0.0001). In addition, the complication rate in the frameless biopsy series was significantly lower than in the frame-based series (p = 0.018). This resulted in lower ITU bed occupancy (p = 0.02), shorter mean hospital stay (p = 0.0013) and significant cost savings (p = 0.0022) for the frameless stereotactic biopsy group, despite the greater use of more expensive MRI in these cases. This comparison study