Prognostic relevance of MIB-1 immunoreactivity, S-phase fraction, 5-bromo-2'-deoxyuridine labeling indices, and mitotic figures in gliomas.

Abstract

Prognostic relevance of cell proliferation markers was evaluated in 27 glioma patients. By 1) flow cytometry (FCM), i.e., S-phase fraction (SPF), and BrdUrd-labeling index (LIfcm); 2) immunohistochemistry (IHC), i.e., BrdUrd-labeling index (LIihc) and MIB-1 immunoreactivity (MIB-1 LIihc); and 3) histologic examination, i.e., the presence or absence of cells in mitoses, were assessed. A longer local progression free survival (LPFS) was significantly associated with low SPF, low LIfcm, and low MIB-1 LIihc. For LIihc, no significant association was found. LIfcm appeared to be a more promising prognosticator than MIB-1 LIihc. In comparison with this marker, the presence or absence of mitotic figures appeared to be an even stronger prognosticator. Prognostic significance of LIfcm appeared to be of importance in low-grade gliomas. The number of patients in our study is limited. Our findings were: 1) the presence or absence of cells in mitoses (M-phase activity) appeared to be of more prognostic significance than LIfcm (S-phase activity) and MIB-1 LIihc (non-G0-phase activity); 2) of the tested experimental cell proliferation markers, LIfcm appeared to be of more prognostic significance than MIB-1 LIihc, SPF, and LIihc; and 3) LIfcm is likely to be an important prognosticator in low-grade gliomas and is, therefore, not definitive and only of potential interest.