PROGNOSTIC RELEVANCE OF CELL-PROLIFERATION MARKERS AND DNA-PLOIDY IN GLIOMAS

The prognostic significance of clinically, histologically and flow cyt ometrically derved parameters was assessed in 49 glioma patients. With flow cytometry, DNA-index, S-phase fraction (SPF), 5-bromo-2'-deoxyur idine (BrdUrd)-labelling index (LI), and potential doubling time (T-po t) were determined. After univariate analysis of clinical variables su ch as, age, seizures as initial symptom, and duration of first symptom were found to be significantly associated both with proliferation rat e and with local progression free suvival (LPFS). Cytomorphological fe atures such as, the presence or absence of mitosis, necrosis, and endo thelial proliferation, were separately analysed and appeared to be sig nificanltly associated with LPFS. With respect to the cell proliferati on markers, we observed a longer LPFS to be associated with a low SPF, a low LI, and a short T-pot. We did not observe a significant associa tion between DNA-ploidy and LPFS. After multivariate analysis both of high and of low grade rumours, we found that neither LI, SPF, nor age had additional prognostic significance for cells in mitoses. We also d emonstrated, that necrosis and endothelial proliferation had no additi onal prognostic significance to that for cells in mitoses. In the subg roup of low grade gliomas, in contrast to high grade gliomas, we noted prognostic significance for LI. We concluded, that i) the presence or absence of cells in mitoses was the strongest single prognosticator i n gliomas, ii) in low grade gliomas LI holds prognostic significance.