The prognostic significance of glial fibrillary acidic protein staining in medulloblastoma

Goldberg‐Stern, Hadassa; Gadoth, Natan; Stern, Sidi; Sandbank, U.; Cohen, Ian J.; Zaizov, Rina

doi:10.1002/1097-0142(19910801)68:3<568::aid-cncr2820680321>3.0.co;2-3

Cited by 41 publications

(8 citation statements)

References 25 publications

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“…Most immunohistochemical studies have shown that expression of neuronal proteins, such as synaptophysin or neurofilament protein, does not influence outcome [45,100,135,218]. Other reports have confusingly suggested that the presence of GFAP‐positive tumour cells bestows adverse [100], beneficial [79], or non‐existent effects on the behaviour of MBs [45,197]. The caveat probably applying to any of these findings is that, whatever morphological or immunohistochemical signs of differentiation are exhibited by a MB (or PNET), its biology will ultimately be dictated by the nature of small undifferentiated cells with a high growth fraction.…”

Section: Prognostic Indicators In Medulloblastomamentioning

confidence: 99%

“…Studies attempting to relate cell proliferation to prognosis in MBs have used a variety of methods for estimating tumour growth. However, whether derived from an index of mitotic activity or a Ki‐67 LI [71,74,79,97,138,146,218], resulting data have been conflicting, many studies showing no relationship with outcome [74,79,97,138,218].…”

Section: Prognostic Indicators In Medulloblastomamentioning

confidence: 99%

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Classifying the medulloblastoma: insights from morphology and molecular genetics

Ellison

2002

Neuropathology Appl Neurobio

202

156

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Significant advances in the treatment of the medulloblastoma (MB) have been made in the last 30 years, reducing mortality by 2-fold. Further improvements in the cure rate require an increased understanding of the biology of MBs, and this will translate into refinements in their classification. Scrutiny of the cytological variation found among MBs has recently led to the concept of the anaplastic MB, which overlaps the large-cell variant and appears to share its poor prognosis. In contrast, the MB with extensive nodularity, a distinctive nodular/desmoplastic variant occurring in infants, has a better outcome than most MBs in these young patients. Building on cytogenetic studies that have drawn attention to abnormalities on chromosome 17 in over a third of MBs, research shows non-random losses on chromosomes 8, 9, 10, 11 and 16, and gains on chromosomes 1, 7 and 9. Overexpression of ErbB2 receptors and losses on chromosome 17p have been proposed as independent indicators of aggressive behaviour, while high TrkC receptor expression indicates a favourable outcome. There is a strong association between anaplastic/large-cell tumours and MYC amplification, which has previously been linked with aggressive disease, but associations between abnormalities on chromosome 17 and anaplastic/large-cell MBs and between abnormalities in the shh/PTCH pathway and the desmoplastic variant are more controversial. Classification of the MB histopathologically and according to profiles of molecular abnormalities will help both to rationalize approaches to therapy, increasing the cure rate and reducing long-term side-effects, and to suggest novel treatments.

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Section: Prognostic Indicators In Medulloblastomamentioning

confidence: 99%

Section: Prognostic Indicators In Medulloblastomamentioning

confidence: 99%

Classifying the medulloblastoma: insights from morphology and molecular genetics

Ellison

2002

Neuropathology Appl Neurobio

202

156

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“…The current case showed evidence of focal glial differentiation, a finding presumed to impart a worse prognosis [29]. The prognostic value of GFAP expression in medulloblastomas is controversial with discrepant findings reporting either a negative [30] or a positive prognostic impact [31]. GFAP expression has also been attributed merely to entrapped astrocytes [32].…”

Section: Discussionmentioning

confidence: 64%

Adult medulloblastoma following fractionated proton therapy for acoustic neuroma

et al. 2012

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Introduction: Radiation-induced medulloblastoma is exceedingly rare. Four cases of adult medulloblastoma were previously reported to have occurred following whole brain or craniospinal irradiation. Development of systemic malignancies secondary to proton beam therapy is extremely uncommon, with a lifetime risk lower than 1 %. Methods and Results: A 39-year-old woman presented with gait instability and a right cerebellar mass following an 8-year latency period post-fractionated proton therapy for an acoustic neuroma. To date, no cases of new onset medulloblastoma have been reported following proton beam therapy. The differential diagnosis by imaging studies includes brain radiation necrosis. Conclusion: The current report highlights the possible, although rare, risks and complications associated with proton beam radiation. Further studies are needed to address issues related to the management and treatment of radiationinduced medulloblastomas.

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“…Another histopathological prognostic parameter in MBs, which has received considerable attention but little agreement, is differentiation along glial or neuronal cell lines. [46] Positivity for GFAP have been variably correlated with better prognosis [47,48] by some, while others found it to be either associated with poor prognosis, [49,50] or without any correlation with survival time. [51,52]…”

Section: Cell Differentiationmentioning

confidence: 99%

Medulloblastomas: New directions in risk stratification

2006

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Medulloblastomas (MBs) are the most common malignant brain tumors in children. Current therapeutic approaches combine surgery, radiotherapy, and chemotherapy. Although, there has been significant improvement in long-term survival rates, the tumor remains incurable in about a third of patients while cognitive deficits and other sequelae of therapy are common among long-term survivors. Hence a major challenge remains to differentiate high-from low-risk patients and to tailor therapy based on the degree of biological aggressiveness. A clinical risk-stratification system has been widely used in MBs based on age, extent of resection and the Chang staging system. However, recent reports indicate that these clinical variables are inadequate methods of defining disease risk. This has prompted search for new markers for MB stratification. Recent studies indicate that the classification of MBs according to profiles of histopathology and molecular abnormalities possibly help better risk-stratification of patients, thereby rationalizing approaches to therapy, increasing cure rate, reducing long-term side effects and developing novel therapeutic strategies. The most accurate outcome prediction till date has been obtained through microarray gene expression profiling. In this article, the current histopathological classification and the recent advances in molecular genetics of MBs are reviewed. Global efforts to translate this knowledge of disease biology into clinical practice especially as outcome predictors are highlighted.

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The prognostic significance of glial fibrillary acidic protein staining in medulloblastoma

Cited by 41 publications

References 25 publications

Classifying the medulloblastoma: insights from morphology and molecular genetics

Classifying the medulloblastoma: insights from morphology and molecular genetics

Adult medulloblastoma following fractionated proton therapy for acoustic neuroma

Medulloblastomas: New directions in risk stratification

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