Clinicopathological Features, MIB-1 Labeling Index and Apoptotic Index in Recurrent Astrocytic Tumors

Angela Mercy RALTE1, Mehar Chand SHARMA1, Asis Kumar KARAK1, Veer Singh MEHTA2, Chitra SARKAR1

1Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
2Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India


This is a study of 64 cases of recurrent astrocytic tumors of all four WHO grades wherein a comparative evaluation of initial vs. recurrent tumor was done with respect to histological grading, MIB-1 labeling index (LI) and apoptotic index (AI). The aim was to identify factor/s that could influence interval to recurrence and/or malignant progression. Recurrence was noted in all grades and upon recurrence, 93.3% of grade II (low grade diffuse) astrocytomas and 63.6% of grade III anaplastic astrocytomas underwent malignant progression. However, none of the Grade I tumors showed evidence of malignant progression. Though interval to recurrence varied considerably, there was a correlation with histological grade of the initial tumor in that grade I and II tumors had a significantly longer mean interval to recurrence (43 months and 54.8 months respectively) as compared to grade III and IV (glioblastoma multiforme) tumors (17.6 and 12.8 months respectively). The interval to recurrence was also longer for grade II and III tumors which showed progression on recurrence (55.3 months for Grade II->Grade III; 54 months for Grade II->Grade IV and 20.6 months for Grade III->IV) as compared to tumors which recurred to the same grade (12.5 months for Grade III->Grade III and 12.8 months for Grade IV->Grade IV). A statistically significant inverse correlation of MIB-1 LI with interval to recurrence was noted. Higher the MIB-1 LI, shorter was the interval to recurrence. Further a cut off MIB-1 LI value of 2.8% could be proposed in predicting recurrence free survival. Interestingly, MIB-1 LI of grade II tumors, which had progressed to grade IV was significantly higher than MIB-1 LI of grade II tumors which had progressed to grade III. Thus, this study establishes the potential role of MIB-1 LI of the initial tumor in determining interval to recurrence. However, apoptotic index has no role in predicting either interval to recurrence or malignant progression. Pathology & Oncology Research, Vol 7, Nr 4, 267-278, 2001

Key words: astrocytic tumors; recurrent; MIB-1 labeling index; apoptotic index; interval to recurrence; progression

Received: Sep 25, 2001; accepted: Nov 19, 2001
Correspondence: Chitra SARKAR, Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India; Tel: 91-11-659 3371, Fax: 91-11-686 2663; E-mail:

Click here to get the full-text version in PDF!