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Ependymomas: MIB-1 proliferation index and survival
A M Ritter1, K R Hess, R E McLendon
1Department of Neurosurgery, Medical College of Virginia, Richmond, USA.
Journal of Neuro-Oncology
|January 5, 1999
Summary
Ependymoma prognosis is linked to MIB-1 proliferation index and histologic features. A MIB-1 index over 20% indicates a poorer outcome, especially in younger patients, alongside specific anaplastic traits.
Area of Science:
- Neuro-oncology
- Pathology
- Cancer Biology
Background:
- Ependymomas exhibit variable biologic behavior, with imprecise correlation to histologic features.
- Accurate prognostic markers are crucial for guiding treatment strategies in ependymoma patients.
Purpose of the Study:
- To correlate malignant histologic characteristics of ependymomas with the MIB-1 proliferation index and patient survival.
- To identify key factors predicting outcomes in ependymoma.
Main Methods:
- Retrospective analysis of 34 ependymoma specimens (1972-1996).
- Histologic assessment for anaplastic features (necrosis, mitosis, vascular proliferation, pleomorphism, nuclear overlap).
- Determination of MIB-1 (Ki-67 antigen) proliferation index.
Main Results:
- Overall median MIB-1 index was 7.8%. An MIB-1 index > 20% significantly decreased survival (RR=5.7, p=0.0013).
- Younger patients (<20 years) showed a higher median MIB-1 index (20.6%) compared to older patients (5.1%).
- Significant histologic predictors of outcome included high mitosis (>5/hpf), necrosis, and vascular proliferation.
Conclusions:
- Poor prognosis in ependymomas is associated with young age, 3-4 anaplastic histologic features, and MIB-1 index > 20%.
- MIB-1 proliferation index serves as a valuable prognostic marker in ependymoma.