Abstract
BackgroundThe WHO classification system for astrocytomas is not considered optimal, mainly because of the subjective assessment of the histopathological features. Few prognostic variables have been found that stratify the risk of clinical progression in patients with grade II astrocytoma. For that reason there is a continuous search for biomarkers that can improve the histopathological diagnosis and prognostication of these tumours.AimThis study was designed to investigate the prognostic significance of the proliferative marker Mcm2 (minichromosome maintenance protein 2) in diffuse astrocytomas WHO grade II and correlate the findings with histopathology, mitoses, and Ki67/MIB-1 immunostaining.Method61 patients with histologically verified grade II astrocytoma (WHO 2007) were investigated. Paraffin sections were immunostained with anti-Mcm2, and the Mcm2 proliferative index (PI) was determined as the percentage of immunoreactive tumour cell nuclei.ResultsMcm2 PI was not associated with any histopathological features but correlated significantly with mitotic count and Ki67/MIB-1 PI (p<0.05). In the survival analyses Mcm2 showed trends to poorer survival, however, statistical significance was not achieved in the univariate analyses (p>0.05).ConclusionsIn our hands Mcm2 immunostaining has no advantage over Ki67/MIB-1 in the evaluation of grade II astrocytomas. Larger studies are needed to fully clarify the prognostic role of this biomarker.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1715002791944037
Highlights
The World Health Organization (WHO) classification system for astrocytomas is not considered optimal, mainly because of the subjective assessment of the histopathological features
Mcm2 proliferative index (PI) was not associated with any histopathological features but correlated significantly with mitotic count and Ki67/MIB-1 PI (p
In our hands Mcm2 immunostaining has no advantage over Ki67/MIB-1 in the evaluation of grade II astrocytomas
Summary
The WHO classification system for astrocytomas is not considered optimal, mainly because of the subjective assessment of the histopathological features. The histopathological criteria for the diagnosis of astrocytic tumours, are given by the World Health Organization (WHO) [1]. This classification system is not optimal, partly due to subjective assessment of the histopathological features. Determination of a tumour’s proliferative activity has gained much interest, for brain tumours [6,7,8,9] This has traditionally been evaluated by counting the number of mitoses. This method still plays a fundamental role in various histological grading schemes, including human astrocytomas [10]. It is encumbered with several disadvantages including the subjective assessment of mitotic figures and confusion with pycnotic cells resulting in considerable interobserver variation [7]
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