Medulloblastoma (MDB) is the most common malignant cerebellar tumor in children. Because of the significant rate of mortality and treatment-related morbidity, the identification of prognostic factors could lead to a more accurate selection of patients who can benefit from a less aggressive therapy and improve risk stratification. Survivin is an inhibitor of apoptosis protein (IAP), the expression of which has been associated with worse prognosis in MDB. However, both of its subcellular localizations may contribute to tumor progression, and ultimately, survivin subcellular localization prognostic value depends on tumor type biological features. The goal of this study was to analyze these survivin features in the pediatric MDB tumor samples and its impact on clinical outcome. Survivin expression and subcellular localization were accessed by immunohistochemistry in a series of 41 tumor samples. Kaplan-Meier survival curves were compared using the log-rank test. Survivin expression ranged from completely absent to fully present in a notably higher pattern of nuclear localization than cytoplasmic (19 of 41 versus 4 of 41, respectively). However, survivin expression and subcellular localization were not associated with five-year overall survival or metastasis status at diagnosis, which was the only statistically significant prognostic factor in our series (p = 0.008). Taken together, our results suggest that survivin expression should be further studied in large, multicenter series to determine its accurate impact on prognosis and pathobiology of pediatric MDB.
benign and malignant cases. Results: In 2008-2009 there were 477904 screening mammography examinations in Hungary. 5.15 % of participating women were recalled. The attendance of re-called women was 92.25 %. Altogether 2092 women (9.7 %) were referred for breast surgery but only 1485 women (71.0 %) underwent surgery. Histological examination confirmed 281 benign (18.9 %) and 1204 malignant (81.1 %) cases. ConClusions: The quality indicators of the Hungarian organized mammography screening program met the recommendations of international professional guidelines. However, in addition to current indicators, new ones should be introduced in order to provide a more comprehensive monitoring of the program.
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