Prognostic significance of neuronal marker expression in glioblastomas

• Published in: Child's nervous system 2012-11, Vol.28 (11), p.1879-1886
• Main Authors: Lee, Kyung-Hwa, Kang, Kyung-Joo, Moon, Kyung-Sub, Jung, Tae-Young, Jung, Shin, Kim, Jae-Hyoo, Kim, Hyung-Seok, Lee, Min-Cheol
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Brain Neoplasms - diagnosis; Brain Neoplasms - metabolism; Brain Neoplasms - mortality; Brain Neoplasms - therapy; Female; Glioblastoma - diagnosis; Glioblastoma - metabolism; Glioblastoma - mortality; Glioblastoma - therapy; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nerve Tissue Proteins - metabolism; Neurofilament Proteins; Neurosciences; Neurosurgery; Original Paper; Phosphopyruvate Hydratase - metabolism; Proportional Hazards Models; Retrospective Studies; Survival Analysis; Synaptophysin - metabolism; Young Adult
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-012-1883-9

Purpose Glioblastomas are the most malignant tumors of central nervous system neoplasms and are well known for their biological heterogeneity. Contrary to the putative hypothesis of purely glial differentiation in glioblastomas, they often demonstrate immunopositivity for neuronal markers. However, the significance of their neuronal marker expression is still controversial. To evaluate the prognostic implication of neuronal expression in glioblastoma, this study investigated the expression of neuronal markers in a large series of glioblastoma patients in terms of patient survival rate. Methods Expression of synaptophysin, neurofilament protein, and NeuN was explored using immunohistochemistry in 88 cases of glioblastoma. Clinicopathological variables as well as patients’ survival data were compared according to the immunopositivity of cases. Results Sixty-one of the 88 tumors (69.3 %) were positive for at least one neuronal marker. Synaptophysin positivity was observed in 43 cases (48.9 %). Neurofilament protein and NeuN were positive in 38 (43.2 %) and 42 cases (47.7 %), respectively. There was no statistically significant difference in overall survival and progression-free survival in association with neuronal marker expression. However, gross total removal or combined radiotherapy and chemotherapy significantly prolonged survival ( P  = 0.041 and 0.044). Cox’s proportional hazard model revealed that NeuN expression was the independent prognostic factors in progression-free survival ( P  = 0.012). Conclusions Although the correlation of neuronal marker expression and clinical outcome in glioblastoma is of considerable interest, the presented data support the limited prognostic value of neuronal marker expression in glioblastoma.