Gliomas: correlation of histologic grade, Ki67 and p53 expression with patient survival.

BACKGROUND Gliomas are grouped into grades 1 to 4 on the basis of morphologic criteria. Grade is the most significant prognostic factor determining survival, but various proliferation markers are being increasingly employed by histopathologists as adjuncts to conventional morphologic variables to determine prognostic behavior of brain tumors. The most widely used and useful of these are MIB1 (Ki67) and p53. OBJECTIVE To correlate World Health Organization (WHO) grades of glial neoplasms and expression of MIB1 and P53 by these tumors with patient survival at the end of one year. MATERIAL AND METHODS 50 consecutive cases with confirmed diagnosis of various histologic types of glial neoplasms were included. Grading was done according to the WHO grading system for CNS neoplasms. Immunohistochemical staining of p53 and MIB1 (Ki67) was performed and scores were calculated. RESULTS A significant correlation was shown between WHO histologic grade and patient survival (p value:0.004) and a marginal correlation was seen between MIB1 score and patient survival (p value: 0.233). CONCLUSION Histologic grade is the most important prognostic factor with respect to patient survival in glial neoplasms. Immunohistochemical staining with MIB1 and p53 may serve as an additional useful toolin determining the clinical course in combination with and as an adjunct to tumor grade. However, the fact that follow-up was available in only twenty out of the fifty cases is a limitation of the present study.