Prognostic value of aldh1, ezh2 and ki-67 in astrocytic gliomas

Abstract

Objective: tumor stem cells have been found in a variety of neoplasms and stated to have a role in tumor progression. This study aimed to evaluate the prognostic significance of biomarkers which are said to be related to these cells, i.e., EZH2, ALDH1 and Ki-67, and their correlation with each other in astrocytic gliomas. Material and Method:Formalin-fixed, paraffin-embedded tissue specimens of 40 patients with astrocytic glioma who underwent initial surgery during the period from December 2011 to May 2014 at Zagazig University Hospitals were enrolled in the study. Consecutive 4-μm thick sections from formalin-fixed, paraffin-embedded tissue blocks were prepared and stained with hematoxylin and eosin for histopathological evaluation. immunohistochemical analysis using ALDH1, EZH2 and Ki-67 antibodies were performed to examine the cases.Results: A total of forty patients; 22 males and 18 females were studied. The lesions were classified as follows: 14 cases of low-grade astrocytoma (WHO grade i or ii), 11 cases of anaplastic astrocytoma (WHO grade iii), and 15 glioblastomas (WHO grade iV). There was a significant increase in ALDH1 immunoreactivity with increasing the grade of astrocytoma (mean ±SD = 0.2 ±0.4, 0.5 ±0.6, 1.1 ±1.3 and 2.95 ±2.97 in grade i to iV astrocytic gliomas, respectively). This expression was significantly correlated with overall survival (OS) and progression-free survival (pFS) (p=0.004). EZH2 expression was also significantly associated with advanced grades (mean ±SD =1.35 ±0.4, 3.1 ±2.6, 7.2 ±3.5 and 9.9 ±4.1, in grade i to iV astrocytic gliomas, respectively). EZH2 and Ki-67 expressions were found to be correlated with OS and pFS (p < 0.001).Conclusion: increased expression of ALDH1, EZH2 and Ki67 are found to be associated with unfavourable prognosis in patients with astrocytic gliomas and may predict therapeutic modalities.

EZH2 overexpression is associated with poor prognosis in patients with glioma

“…Two studies [15, 17] were conducted in China, one [16] was performed in Canada, one [18] was in Egypt, one [19] was in India and one [20] was in Germany, respectively. Four studies [15, 16, 18, 19] examined EZH2 expression by immunohistochemistry staining (IHC) and two [17, 20] used genetic testing. All six studies investigated the prognostic value of EZH2 for OS and three studies [16, 18, 19] explored the association between EZH2 and PFS.…”

“…Four studies [15, 16, 18, 19] examined EZH2 expression by immunohistochemistry staining (IHC) and two [17, 20] used genetic testing. All six studies investigated the prognostic value of EZH2 for OS and three studies [16, 18, 19] explored the association between EZH2 and PFS. The detailed characteristics of included studies were depicted in Table 1.…”

“…Three studies [15, 17, 18] exploited the relevance between EZH2 and gender as well as KPS score and two studies [15, 18] reported the association between EZH2 and age. The combined data showed that high EZH2 expression significantly associated with lower KPS score ( n = 3, OR = 5.25, 95% CI: 1.35–20.44, p = 0.017, Table 3, Figure 3A) whereas EZH2 was not shown to be related with gender ( n = 3, OR = 1.04, 95% CI: 0.62–1.73, p = 0.883, Table 3, Figure 3B) or age ( n = 2, OR = 2.2, 95% CI: 0.44–10.91, p = 0.335, Table 3, Figure 3C).…”

The diagnostic and prognostic values of Ki-67/MIB-1 expression in thyroid cancer: a meta-analysis with 6,051 cases

“…Ki-67/MIB-1 is the most widely used marker for assessing the proliferative capacity of tumor cells. Increased expression of Ki-67/MIB-1 has been linked to increased invasiveness in many cancers 10,65–67. Many meta-analyses have shown that high expression of Ki-67/MIB-1 contributed to poor survival in many tumors 68–72.…”

Primary Astrocytic Tumours and Paired Recurrences have Similar Biological Features in IDH1, TP53 and TERTp Mutation and MGMT, ATRX Loss

“…Together with IDH1 gene mutation, MGMT protein expression level and Ki67 index were identified as independent prognostic factors for PFS in multivariate Cox regression analysis. The value of Ki67 and MGMT as independent prognostic factors in glioma was reported previously 51–55 . We classified 47 astrocytic tumours into 3 groups based on IDH1 mutation status and MGMT and Ki67 expression level without considering histological grade.…”