The Relationship of Ki-67, Proliferating Cell Nuclear Antigen, AgNORs and p53 Protein Expression in Astrocytoma

The grading of astrocytoma has traditionally relied on histological assessment, but there are some differences in their parameters, application, and reproducibility. Recently, numerous studies have attempted to correlate biological aggresiveness with tumor proliferation index using new immunohistochemical methods. The purpose of this study is to correlate the histopathological grades of astrocytoma with the expression of Ki-67, PCNA, p53 protein and AgNORs. The paraffin sections of 41 consecutive cases of astrocytomas were examined. Histologically the tumors were graded as three groups under the St. Anne-Mayo system and showed 14 cases in grade II, 15 cases in grade III and 12 cases in grade IV (glioblastoma multiforme). As a result, the Ki-67 labelling index and p53 protein expression tended to increase with increasing grade of malignancy. But the univariate analysis showed that there was no significant difference between the tumor grades (p>0.05). The PCNA labelling index and number of AgNORs revealed striking differences between the grade II and grade III astrocytomas (p<0.05). We concluded that the PCNA labelling index and AgNORs counting are useful markers for differentiation between grade II and III astrocytomas.

Intracranial Fibro-Osseous Lesion: A case report and literature review

Intracranial fibro-osseous lesion, also reported as calcifying pseudoneoplasm of the neural axis, is an uncommon lesion of the central nervous system. Since the discovery of this entity by Rhodes and Davis in 1978, there have been a total of 21 cases reported in the literature. We encountered one such case in a 28 year old male, who presented with left hemiparesis for 1 year. By the MR images, a 1.5 cm sized round mass was found at right parietal lobe near motor cortex. The mass lesion enhanced well, homogenously and revealed clear, slightly irregular margin. Excisional biopsy of the mass was performed. Microscopically the lesion was composed of calcified fibrous tissue with an amorphous gray-blue, coarsely fibrillar to chondromyxoid nodular areas. Sparse spindle cells, immunohistochemically negative for GFAP, vimentin and S-100, were scattered within the amorphous material. Palisading spindle or polygonal cells were present at the more cellular periphery of the lesion, which were vimentin positive but S-100 negative. There was no evidence of the pilocytic astrocytes, Rosenthal fibers, or GFAP positive hypertrophic astrocytes. Intracranial fibro-osseous lesions are apparently slow-growing with generally excellent prognosis after wide excision. The etiology remains unclear, but most investigators favor a reactive rather than neoplastic process.