Study of the MIB-1 Labeling index as a predictor of tumor progression in pilocytic astrocytomas in children and adolescents
Study of the MIB-1 Labeling index as a predictor of tumor progression in pilocytic astrocytomas in children and adolescents
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DOI：
10.1200/jco.2003.01.017
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发表时间：
2003-08-01
影响因子：
45.3
通讯作者：
Margraf, LR
中科院分区：
文献类型：
--
作者：
Bowers, DC;Gargan, L;Margraf, LR
目的：毛细胞性星形细胞瘤（PA）是儿童最常见的脑肿瘤。本报告探讨了MIB-1标记指数（LI）作为儿童PAs.Patients和方法之间的无进展生存期（PFS）的预测因子：检查连续性PA，以确定MIB-1 LI是否与肿瘤进展相关。评估的其他变量包括肿瘤的位置，使用辅助治疗，切除的程度，和诊断时的年龄。结果：141名儿童被确定（平均值+/- SD年龄，7.6 +/- 4.7岁;范围，0.43至18.56岁）; 118名儿童有足够的组织MIB-1免疫组化。5年PFS为61.25%。通过对数秩分析，MIB-1 LI大于2.0与PFS缩短相关（P = 0.035）。接受完全手术切除、肿瘤位于小脑且仅接受手术治疗的PA患者的PFS也更长（所有患者P = 0.001）。视神经通路中的肿瘤与较短的PFS相关（P = .001）。将MIB-1 LI的评价限制为仅不完全切除的肿瘤，显示MIB-1 LI大于2.0具有缩短PFS的不显著趋势。多变量分析表明完全切除肿瘤和位于小脑的肿瘤不太可能进展（P = 0.001和0.019，分别）。完全切除并位于小脑的PA具有延长的PFS。该初步研究表明，MIB-1 LI识别了更具侵袭性的PA子集。进一步的工作应该集中在阐明毛细胞星形细胞瘤的特点，这将确定前瞻性的儿童在发展的风险。
Purpose: The pilocytic astrocytoma (PA) is the most common childhood brain tumor. This report examines the MiB-1 labeling index (LI) as a predictor of progression-free survival (PFS) among childhood PAs.Patients and Methods: Consecutive PAs were examined to determine whether the MIB-1 LI was associated with tumor progression. Other variables evaluated included tumor location, use of adjuvant therapy, extent of resection, and age at diagnosis.Results: One hundred forty-one children were identified (mean +/- SD age, 7.6 +/- 4.7 years; range, 0.43 to 18.56 years); 118 children had adequate tissue for MIB-1 immunohistochemistry. The 5-year PFS was 61.25%. By log-rank analysis, an MIB-1 LI of more than 2.0 was associated with shortened PFS (P = .035). Patients with PAs who underwent complete surgical resection, had tumors located in the cerebellum, and were treated with surgery only also had more prolonged PFS (P = .001 for all). Tumors in the optic pathways were associated with a shorter PFS (P = .001). Restricting the evaluation of MIB-1 LI to only incompletely resected tumors revealed an insignificant trend of MIB-1 LI of more than 2.0 having a shortened PFS. Multivariate analysis demonstrated completely resected tumors and tumors located in the cerebellum as less likely to progress (P = .001 and .019, respectively).Conclusion: Children with PAs with an MIB-1 LI of more than 2.0 have a shortened PFS. PAs that are completely resected and are located in the cerebellum have a prolonged PFS. This initial study suggests that the MIB-1 LI identifies a more aggressive subset of PAs. Further work should focus on elucidating features of pilocytic astocytomas that will identify prospectively children at risk for progression.