Histopathologic Diagnosis, Cell Cycle Parameters and Clinical Behavior of 90 Egyptian Brain Tumor Cases

Abstract

This work aims at assessment of factors contributing to cell proliferation in relation to histopathologic diagnosis and clinical outcome of 90 brain tumour cases from Egypt. Cases were taken prospectively from the Neurosurgery Department of Mansoura University Hospitals, Egypt. Their median age was 46 years and their sex included 42 (46.7%) males and 48 (53.3%) females. Of these cases, 14 cases (15.6%) had an age <20 years. Brain biopsy samples were processed for histopathologic examination in addition to flow cytometeryic analysis of DNA ploidy pattern, apoptosis, p53 and Bcl2 expressions. Meningeal tumors were most frequent (37.8%) followed by astrocytic tumors (26.7%), sellar tumors (12.2%) while the neuroblastic tumors were detected in 10% of cases. Females were more affected by meningiomas and pituitary adenomas whereas males were more affected by astrocytic tumors. Older cases were affected mostly by meningeal and astrocytic tumors while the younger ones were more affected by neuroblastic tumors. Malignant tumors showed significant increased levels of mutant p53 expression, S phase of both diploid and aneuoploid cells than benign ones (P<0.05). On follow up, most of the cases affected with meningeal tumors had become symptom free while recurrence and death were mostly observed in astrocytic tumors. Significant increased expression of mutant p53 was also observed among recurrent cases (p<0.05) than cases that become free of symptoms. These results shows that cell cycle markers in addition to histopathology can help in predicting prognosis of brain tumours with a potential impact on management plan.