Forty cases of astrocytic tumors were studied; 47.5% AST,
40% ANA and 12.5% G.B.M. Tumor DNA ploidy was analysed
on paraffin-embedded and Feulgen stained tissue sections by
the CAS-200 image analysis system. Follow up of the cases for
40 months was also studied to correlate histopathologic grades
and DNA ploidy of tumors with the patient free survival time
in trial to find out their prognostic value. The current study
showed that the histopathologic grading of astrocytic tumors
by means of a three division classification; astrocytoma (AST),
artaplastic astrocytoma (ANA) and glioblastoma multiforme
(GBM), had a significant prognostic value (73.6% of patients
with AST, 43.75Zof ANA group and only 20% of GBM group
were surviving free after 40 months follow up). Considering
DNA ploidy characterization, it showed that aneuploid AST
and ANA tumors were associated with longer mean patient
free survival time (all 5 cases of aneuploid AST and 46.4% of
ANA were surviving free till 40 months follow up) compared
with euploid AST and ANA tumors (71.4%, 33.3% respectively).
Not only high grade astrocytic tumors (ANA and GBM) but
26.3% of low grade astrocytic tumor (AST) were aneuploid,
which means that classifying DNA ploidy into euploid (DI <1.3)
and aneuploid (DI 1.3) types is unreliable to charcterize the
grade of astrocytic tumors.
Recognizing six DNA histogram types (diploid, triploid,
tetraploid, hyperdiploid, hypertriploid and polymorhic), is a
reliable method in determining the outcome of astorcytic
tumors it was observed that triploid or near triploid
(hyperdiploid and hypertriploid) astrocytic tumors (87.5% ,
100% respectively) were associated with longer mean patient
free survival time compared with that in cases of the other
DNA histogram types regardless of the histopathologic grade
of the tumor.
In conclusion, this study suggests that in case of astrocytic
tumors, histopathologic grading and DNA ploidy (at DI and
DNA histogram pattern levels) could be helpful as shared
prognostic values. |
