A Comparative Study on MIB-1, AgNORs and PCNA Expressions in Astrocytic Tumors

Cell cycle associated nuclear proteins such as proliferating cell nuclear antigen(PCNA), argyrophilic nucleolar organizer regions(AgNORs) and the family of nuclear proteins identified by the Ki-67 epitope, have been primarily utilized for estimating of growth potential of neoplasms. Although PCNA and AgNORs staining are possible in the paraffin-embedded tissue, Ki-67 staining had been only possible on frozen sections. Recently monoclonal antibody MIB-1 is available, and reacts with the Ki-67 epitope in paraffin-embedded tissue. Twenty eight astrocytic tumors in paraffin-embedded, archival materials were stained by immunohistochemical technique for the MIB-1, PCNA, and by silver colloid stain for AgNORs. The MIB-1 labeling indicies(LI) ranged from 2 to 25%(10+/-7.58) for 10 glioblastomas; from 2 to 15%(7+/-3.74) for 11 anaplastic astrocytomas; and from 1 to 5%(3+/-1.91) for low grade astrocytomas. Glioblastomas and anaplastic astrocytomas exhibited significantly higher MIB-1 LI than their benign counterparts(p<0.05). The AgNORs count per cell ranged from 1.3 to 3.1(1.96+/-0.57) for 10 glioblastomas: from 1.2 to 3.1(1.9+/-0.64) for 11 anaplastic astrocytomas: and from 0.8 to 1.5(1.2+/-0.26) for low grade astrocytomas. Glioblastomas and anaplastic astrocytomas exhibited significantly higher AgNORs count than their benign counterparts(p<0.05). The PCNA LI ranged from 10 to 40%(24.5+/-10.39) for 10 glioblastomas; from 5 to 20%(11.6+/-5.24) for 11 anaplastic astrocytomas; and from 5 to 10%(7.1+/-2.67) for low grade astrocytomas. The differences of PCNA LI between glioblastomas and anaplastic astrocytomas(p<0.01), and between glioblastomas and low grade astrocytomas(p<0. 001) were statistically significant. Linear regression analysis showed correlations between MIB-1 LI and AgNORs count(Spearmans r=0.4306, p<0.05), between PCNA LI and AgNORs count(Spearman's r=0.586, p<0.05) and between PCNA and MIB-1 LI(Spearman's r=0.4523, p<0.05). These findings suggest that LI of MIB-1, PCNA and AgNORs count are correlated each other, and can be used as helpful markers for differentiating astrocytic tumors in addition to conventional staining methods.

A Case of Meningioma in Temporo-occipital Lobe without Dural Attachment in a 14-yer-old Girl: Case Report

Meningiomas are thought to arise from the arachnoid cap or meningothelial cells. This frequent apposition to the dura mater probably accounts for the usual attachment of the neoplasm to this layer. We report a case of intraparenchymal meningioma without dural attachment in a 14-year-old girl. A survey of the literature reveals that the majority of cases of meningiomas without dural attachment occur either in children or below the tentorium, and most of them located in the ventricle, the cranial vault. Intraparenchymal meningioma without dural attachment, however, are extremely rare. The uncommon locations of meningiomas at sites distant from the duramater is believed to reflect the rare occurrence of arachnoid cap cells in the Virchow-Robin spaces along the cerebral vasculature or in the pial layers distant from the dura mater.

Clinical Parameters Associated with Vasospasm in Early-Operated Aneurysmal Subarachnoid Hemorrhage

Much controversies still exist with respect to the risk factors influencing symptomatic cerebral vasospasm. In our study, the patient group had some unique characteristics, ie.:42.5%(65) of the 153 patients were aged 60 years or older(mean;55.6 years) and consequently the proportion of Hunt-Hess grade 3-5 was higher than grade 1-2(57.5% vs 42.5%). The authors analyzed the relationship between vasospasm and Hunt & Hess grade, Fisher grade, hydrocehalus, age & hypertension among these 153 early operative cases after a 3 year follow up study. The incidence of vasospasm was significantly higher in the Hunt-Hess grade III, IV, V and the Fisher grade III, IV, compared to grade I & II, and also in preoperative hydrocehalus but it was insignificant in old and hypertensive patients. These results suggest initial severe direct insults and complicating preoperative hydrocephalus increase the chance of postoperative symptomatic vasospasm in this older aged, poorer grade study group.