The brain tumour project
In the brain tumour project we study prognostic factors by examining tissue samples from brain tumours of the classifications astrocytomas and meningiomas. The predominant methods are immune histo-chemistry and in situ hybridisation.
We focus in particular on proteins (antigens) associated with tumour growth, such as proliferation markers, and growth factors and their receptors. The expression of such biomarkers or changes in their genes (e.g. mutations) are compared with prognosis (recidivation or death) and tumour grade (histological evaluation of the malignancy grade). If any of the markers display clinical significance, it may be relevant for either diagnostics, prognostics or treatment options.
So far we have shown that in astrocytomas grade II/III, the proliferation index assessed using mitosin, survivin, phosphohiston (phh3) and DNA topoisomerase IIα, is statistically associated with poorer prognosis (increased residive tendency and shorter survival) (1,2). The same holds for increased expression of the growth factor receptor c-erbB2/HER2 (3).
When it comes to meningeomas, a survey of a larger data set shows that the occurrence of more aggressive meningeomas (atypical meningeomas of WHO grade II) are higher than previously thought (about 30% of the meningeomas) (4). A consequence of this could be that a larger number of patients should be monitored more closely to discover any residive earlier. This could also lead to more patients needing more active treatment (surgery/radiation).
Furthermore we have found that the absence of so-called psammoma bodies, the presence of necrosis and four or more mitosis have a stronger prognostic value when it comes to the risk of residive than the WHO classification (5).
- Varughese RK, Lind-Landström T, Habberstad AH, et al. Mitosin and pHH3 predict poorer survival in astrocytomas WHO grades II and III. J Clin Pathol. 2015.
- Habberstad AH, Gulati S, Torp SH. Evaluation of the proliferation markers Ki-67/MIB-1, mitosin, survivin, pHH3, and DNA topoisomerase II alpha in human anaplastic astrocytomas - an immunohistochemical study. Diagn Pathol. 2011;6:8.
- Gulati S, Ytterhus B, Granli US, et al. Overexpression of c-erbB2 is a negative prognostic factor in anaplastic astrocytomas. Diagn Pathol. 2010;5:18.
- Backer-Grondahl T, Moen BH, Torp SH. The histopathological spectrum of human meningiomas. Int J Clin Exp Pathol. 2012;5:231-242.
- Backer-Grondahl T, Moen BH, Sundstrom SH, et al. Histopathology and prognosis in human meningiomas. APMIS. 2014;122:856-866.