Gemistocytes in astrocytomas: Are they a significant prognostic factor?

Abstract

Our aim was to retrospectively evaluate the influence of gemistocytic astrocytes, cellular proliferation indices, immunoexpression of proteins p53 and bcl-2 in the clinical outcome of 39 patients with WHO grade II and III astrocytomas with the presence of gemistocytes. The mean proportion of gemistocytes was 18.7% and the mean proliferative index was 3.3%. Immunoexpression of p53 was detected in 29 cases (74.4%) and all cases (100%) were positive for bcl-2. The median overall survival was 97.2 months and the progression-free survival was 43.1 months. Estimated 1-, 5- and 10-year overall survival rates were 94.3%, 69.5% and 46.4%; 1-, 5- and 10-year progression-free survival rates were 91.1%, 26.1% and 13.1%. Out of 24 who presented clinical and neuroimaging worsening, characterized as tumor progression or recurrence, 16 had histological confirmation and were also analyzed. We could not detect significant differences when comparing all the indices between WHO grade II and III and also between the first and second biopsies. We also could not detect significant differences in progression-free and overall survival when analyzing the gemistocyte index and the immunohistochemical labeling indices p53, bcl-2 and MIB-1, as well as patientsa9 age (median value, up to 34 vs. over 34 years) and histological grade (II or III). Our finding confirms recent reports that question the role of gemistocytes as a prognostic factor in diffuse astrocytomas. The significance and role of gemistocytes in astrocytomas has yet to be defined and warrants further study.

Established and emerging variants of glioblastoma multiforme: review of morphological and molecular features

“…In fact, this threshold of gemistocytic cells in astrocytomas has been shown to significantly impact overall and progression-free survival [85]. However, other studies have suggested that gemistocytic components in astrocytomas do not correlate with age, p53 expression, or MIB-1 staining, or survival [54,94].…”

Loss of prostaglandin D2 synthase: a key molecular event in the transition of a low-grade astrocytoma to an anaplastic astrocytoma

“…Astrocytoma malignant progression was reported to be more rapid in patients with an AII containing more than 5% gemistocytes (3). However, other studies have shown no such correlation (4). Several genes such as TP53 (5 -7), epidermal growth factor receptor (8,9), and platelet-derived growth factor receptor (10) have been associated with the tumorigenesis and anaplastic progression of human gliomas, but the prognostic significance of these genes has also been unclear.…”

The Proliferative Activity (Ki-67) and the Level of Vascular Endothelial Growth Factor (Vegf) Gene Expression in Gemistocytic Astrocytomas

“…В литературе можно встретить лишь небольшое количество работ, которые освещают непосред-ственно ГА [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. По сравнению с диффузными астроцитомами GII они характеризуются более агрессивным биологическим поведением, что проявляется более короткой общей выживаемо-стью пациентов (38-49 мес и 69-89 мес.…”