Prospective observational study of intracranial and spinal ependymomas with special reference to immunohistochemical markers in relation to short-term prognosis

Abstract

The aim of the study was to analyze the intracranial and spinal ependymomas with special reference to immunohistochemical markers in relation to short term prognosis. The present prospective study was conducted in the Department of Neurosurgery, Bangur Institute of Neurosciences and SSKM Hospital, IPGME and R, Kolkata from April 2020 to December 2021 in the Neurosurgery ward. 30 cases admitted in the department operated for suspected cases of intracranial and spinal ependymomas irrespective of any age groups and histologically confirmed thereafter by Pathology Department of SSKM hospital, IPGMER were included in the study. Age, sex, mode of presentation, clinical symptomatology, clinical findings, clinical, radiological investigations, surgical details, outcome data was recorded. The clinical follow-up observation was carried out by outpatient review. The patients were regularly followed up at 3, 6 and 12 months operation. Intracranial and spinal location was reported among 21 (70%) and 9 (30%) subjects respectively. During surgery, complete resection was achieved in 80% of the subjects. Out of 30 subjects, 90% of the subjects survived whereas mortality happened in 10% of the subjects. Most common complication was cranial nerve palsy (33.33%). The mean Ki-67 and p53 proliferative indices were significantly higher in grade III tumors as compared to grade II and grade I tumors. EMA was found to be positive in 70% of the subjects. The results concluded that p53 and Ki 67 indices when performed in routine diagnostic cases can supplement the histological diagnosis and at the same time these values could predict the relative difference in prognosis of various subtypes.