1. Markers of cell division cycle in glioblastoma: significance in prediction of treatment response and patient prognosis.
- Author
-
Yousaf J, Hills C, Dixit S, Achawal S, O'Brien D, Greenman J, and Scott IS
- Subjects
- Aged, Antineoplastic Agents therapeutic use, Biomarkers, Tumor, Biopsy, Brain Neoplasms surgery, Cell Cycle Proteins analysis, Chemoradiotherapy, Combined Modality Therapy, Cyclin A analysis, Cyclin A metabolism, Female, Geminin analysis, Geminin metabolism, Glioblastoma surgery, Humans, Immunohistochemistry, Karnofsky Performance Status, Male, Microarray Analysis, Middle Aged, Minichromosome Maintenance Complex Component 2 analysis, Minichromosome Maintenance Complex Component 2 metabolism, Neoplasm Recurrence, Local epidemiology, Neoplasm Recurrence, Local pathology, Prognosis, S Phase drug effects, Survival Analysis, Treatment Outcome, Brain Neoplasms pathology, Cell Cycle physiology, Cell Division physiology, Glioblastoma pathology
- Abstract
Objective: To investigate whether expression of regulatory components of the cell division cycle can be used independently to predict survival and response to adjuvant therapy in glioblastomas., Method: A tissue micro-array, constructed using glioblastomas (n = 66), was stained using antibodies against minichromosome maintenance protein-2 (Mcm-2), expressed throughout the cell-division cycle; geminin, a protein that prevents re-initiation of DNA replication; and cyclin A, an S-phase cyclin. A semi-quantitative labelling index (LI) was calculated using an average of 18 high-power fields (hpf) in three replicate cores. The patients were divided into two groups: Group 1 (n = 50) underwent surgery and radiotherapy with 24 patients receiving temozolomide, and Group 2 (n = 16) received surgical treatment only., Results: The LIs (median +/- IQR) for Group 1 were as follows: Mcm-2, 36.7% (22.9%-51.8%); geminin, 7.8% (5.8%-10.5%); and cyclin A, 4.2% (2.4%-6.9%). Elevated LIs, higher than the median, for geminin and cyclin A correlated with prolonged survival when the tumours received adjuvant therapy (Kaplan-Meier curves, p = 0.0046 and p = 0.0063 for geminin and cyclin A, respectively). Linear regression analysis revealed positive correlations with survival for Mcm-2 (p = 0.0376), geminin (p = 0.0006) and cyclin A (p = 0.004). In Group 2, there was no relationship between the patient survival and the LI for any marker., Conclusions: Geminin and cyclin A, each show potential as independent prognostic markers in glioblastomas receiving adjuvant therapy. This may reflect the fact that both geminin and cyclin A estimate proliferating tumour cell subpopulations sensitive to radio/chemotherapy. These markers could provide valuable prognostic information, even in small biopsies, especially if combined with O(6)MGMT expression and 1p;19q deletion status.
- Published
- 2013
- Full Text
- View/download PDF