OBJECTIVE: PTEN is a novel tumor-suppressor gene located on chromosomal band 10q23. Loss of PTEN function has been implicated in the progression of several types of cancer, including glial tumors. This study is performed to evaluate the difference of PTEN expression between the low grade glial tumors and the high grade one. METHODS: Formalin fixed and paraffin embedded tissues from 15 patients with low grade astrocytoma and oligodendroglioma, and 26 patients with glioblastoma, anaplastic astrocytoma, anaplastic oligodendroglioma and malignant mixed glial tumor were evaluated for PTEN expression by immunohistochemical method. RESULTS: Eleven(73%) of 15 cases of low grade glial tumors revealed PTEN expression and eight(31%) of 26 cases of high grade glial tumors, including glioblastoma, revealed PTEN expression. CONCLUSION: The present study suggests that loss of PTEN expression is related with tumor progression from the low grade glial tumor to glioblastoma.
Astrocytoma ; Brain* ; Formaldehyde ; Glioblastoma ; Humans* ; Oligodendroglioma ; Paraffin

A retrospective analysis of survival data of 52 cases with brain astrocytomas was presented. All patients received post-perative radiotherapy in the period of 1973~1983 at YUMC, Yonsei Cancer Center. There were 24 patients with Grade II, 12 patients with Grade III and 16 patients with Grade IV astrocytomas. Survival rates were analyzed according to histologic grade of malignancy, age, tumor location. radiation dose and extent of surgical tumor resection. 5 year actuarial survival for patients with Grade II astrocytomas was 32.9% ad Grade III was 42.9%. The 1 year and 2 year survival rate of Grade IV astrocytomas were 46.7% and 0%. Histologic grade of tumor was important prognostic factor in brain astrocytomas. Age and extent of surgical resection were significant prognostic factors in all grades of astrocytomas and tumor location and radiation dose were significant in Grade II astrocytomas.
Astrocytoma* ; Brain* ; Glioblastoma ; Humans ; Radiotherapy* ; Retrospective Studies ; Survival Rate

OBJECTIVE: Growth of cerebral gliomas depends on their neovascularization and invasion into the adjacent neural tissue. There are several extracellular and intracellular factors affecting its growth. Tenascin(TN) is a type of extracellular matrix(ECM) protein which may be responsible for the migration of neoplastic cells and tumor angiogenesis, but its exact role has not been established. We studied the relation between the expression of TN and the histological grade of the glial cell tumors as well as to determine the expression of TN-C in tumor vessel. PATIENTS AND METHODS:In the fifty-six patients with glial cell tumors, we characterized the expression of tenascin-C(TN-C) in the neoplastic vessel, intercellular network, and tumor cell by immunohistochemistry using monoclonal antibody. The relationship between the histological malignancy and TN-C expression was evaluated. In addition, TN-C expression of the tumor vessels was also examined. RESULTS: The tumors included 32 glioblastomas, 13 astrocytomas, 4 pilocytic astrocytoma, 3 anaplastic astrocytoma, 1 pleomorphic xanthoastrocytoma, 1 oligodendroglioma, 1 anaplastic oligodendroglioma, and 1 mixed oligoastrocytoma. TN-C expression in intercellular network of glioblastoma, anaplastic astrocytoma, and astrocytoma was 87. 5%, 66.7%, and 61.5%, respectively. There was a close relationship between the TN-C expression and histological grade of the glial cell tumors. In 28(87.5%) of 32 glioblastomas, TN-C was significantly expressed in the tumor vessels(p<0.05). CONCLUSION: Present results demonstrate that TN-C in the glial cell tumors may be identified as a one of the related factors contributing to malignant progression. And also, enhanced expression of TN-C in the tumor vessels of glioblastoma indicate the possibility that TN-C could be involved in neoplastic angiogenesis.
Astrocytoma ; Glioblastoma ; Glioma* ; Humans ; Immunohistochemistry ; Neuroglia* ; Oligodendroglioma ; Tenascin*

The natural history of low-grade astrocytomas is variable. Although many patients survive for an extended period of time, other patients have a rapidly progressive course and early death. In order to determine the specific prognostic factors in low-grade astrocytoma(LGA) patients with uniform contemporary technique, data from 41 consecutive supratentorial LGA patients(>or=18 years of age) treated with radiation therapy following incomplete resection between June 1989 and May 1993 at our hospital were analyzed. Variable factors were examined for their association with survival: age at the time of diagnosis, gender, length and type of neurological symptoms, preoperative neurological status, contrast enhancement pattern on CT, and extent of the lesion as defined by CT/MRI. The following characteristics were associated with improved patient survival by univariate analysis(p<0.05): onset of symptom to treatment >12 months, and seizure as a presenting symptom at the time of admission. Other factors were not significant in determining the length of survival. Overall acturial survival at 3 and 5 years was 82% and 70%, respectivley. Nine of these 41 patients had tumor recurrences/progressions with a mean time of 20.6 months. Among 9 tumor recurrences/progressions, second surgery was perfomed in 5 patients and 3 of these 5 patients had progressed to high-grade lesions(2 glioblastoma multiformes, 1 anaplastic astrocytoma). Seven patients died from tumor progression/recurrence. Concerning surgical removal, an attempt should be made, whenever possible, for a gross total resection. But, when that is not possible, we think that biopsy or partial debulking without undue risk of significant neurologic compromise followed by radiation therapy can serve as an alternative treatment option in supratentorial LGAs.
Adult* ; Astrocytoma* ; Biopsy ; Diagnosis ; Glioblastoma ; Humans ; Natural History ; Recurrence ; Seizures

A retrospective analysis was performed on 49 patients with astrocytoma of glioblastoma multiforme of brain who received postoperative radiotherapy in the period between February 1979 and December 1985. Fourteen patients had grade I astrocytoma, 11 patients grade II, 14 patients grade III, and 10 patients glioblastoma multiforme. Three year actuarial surival rates were 85.7%, 44.6% and 23.1% for grade I,II, and III astrocytomas, respectively. One and 2 year actuarial survival rates for patients with glioblastoma multiforme were 54.5% and 27.3%, respectively. Histologic grade, age, extent of operation and tumor location were revealed to be prognosticators.
Astrocytoma* ; Brain* ; Glioblastoma* ; Humans ; Radiotherapy* ; Retrospective Studies ; Survival Rate

Five patients with brain tumors have been treated with an afterloaded removable Iridium-192 interstitial brachytherapy using Brown-Roberts-Wells stereotactic system. There were two cases of glioblastoma multiforme, one case of recurrent glioblastoma multiforme, one case of recurrent metastatic brain tumor and one case of recurrent astrocytoma grade II. The patients were treated by combination of surgery or stereotactic biopsy and external radiation previously. Tumor doses ranging from 4100 to 8600 cGy were delivered to these patients. There was no death and 4 patients showed definite tumor regression 3 months following interstitial brachytherapy. The method was safe and appeared to be effective madality to achieve local control of brain tumors.
Astrocytoma ; Biopsy ; Brachytherapy ; Brain Neoplasms ; Brain* ; Glioblastoma ; Humans

Glioblastoma multiforme (GBM) is the most common primary brain tumor and the most malignant astrocytoma in adults, with rare extra-cranial metastases, especially for subcutaneous metastases. It could be easily misdiagnosed as primary subcutaneous tumor. In this report, we describe a patient with pontine GBM who developed a subcutaneous swelling at the ipsilateral posterior cervical region 8 months after operation, and the pathological and immunocytochemical examination carry the same characteristics as the primary intracranial GBM cells, which defined it as subcutaneous metastasis. GBM with subcutaneous metastasis is extremely rare, and knowledge of a prior intracranial GBM, pathological examinations and immunocytochemical tests with markers typically expressed by GBM are of vital importance for the diagnosis of GBM metastasis. Surgical resection of subcutaneous swelling, followed by chemotherapy and radiotherapy, could be the best strategy of treatment for the patients with GBM subcutaneous metastasis.
Adult ; Astrocytoma ; Brain Neoplasms ; Glioblastoma ; Humans ; Neoplasm Metastasis

Forty-four patients with brain astrocytoma and glioblastoma were treated with surgical resection and postoperative radiation from January 1980 through May 1987. Four patients were lost to follow up, and in 40 patients sruvival time was evaluable. Three year actuarial sruvival rate was 66.7% in Grade I and II astrocytoma, 30% in Grade III, and 20.4% in glioblastoma multiforme patients. The prognostic factors affecting survival rate were histologic grade in all cases, age, and total radiation dose in Grade III and glioblastoma.
Astrocytoma* ; Brain ; Glioblastoma* ; Humans ; Lost to Follow-Up ; Survival Rate

Nineteen astrocytic neoplasms, such as 9 cases of glioblastoma multiforme, 6 cases of anaplastic astrocytoma and 4 cases of low grade astrocytoma, were analysed in view of the relationship between histopathologic grade, nuclear pleomorphism, grade of mutant p53 gene expression and mean survival time after operation. The histopathologic classification by Ringertz and immunohistochemical stain for mutant p53 gene with the DO-7 anti-p53 oncoprotein mouse monoclonal antibody were applied, and the results obtained were as follows; 1) Among 19 cases, 18 cases were located in the supratentorium, where 13 cases(42%) were located in the left and 17 cases(55%) in the right. 2) The p53 gene expression was detected in 12(63.2%) of the cases, as revealed by positive nuclear staining. All cases of glioblastoma multiforme showed p53 gene expression, compared with two(33.3%) cases of anaplastic astrocytoma and one(25%) case of low grade astrocytoma. The frequency and degree of histopathologic grade(p=0.03). 3) The mean survival time after operation was 29.49+/-4.08 months in cases with p53-negative tumors and 12.93+/-3.14 months in cases with p53-positive tumors(p<0.05). 4) Both histopathological classification and p53 gene expression showed a significant influence on servival(p=0.02 and p=0.03, respectively). 5) The relative risk for survival time was the highest in p53 gene expression. In conclusion, p53 gene expression appears to be one of the recommendable prognosticators among astrocytic neoplasms.
Animals ; Astrocytoma ; Classification ; Genes, p53* ; Glioblastoma ; Mice ; Survival Rate

Fractionation dose and number have been known as radiation factor affecting the radiation complication and the effectiveness in radiotherapy for brain tumors. In this study hyperfractionation technique with 115cGy/fractioin 2 fractions daily 5days/wk, upto 5750-6900cGy to partial brain volume was compared with conventional fractionation technique with daily 200cGy/fraction 5 fraction/wk, upto 5400-6000cGy, in regarding to the effectiveness of hyperfractionated radiotherapy and eraly and later radiation reavtion. The survival period was longer in hyperfractionated irradiated group particularly if the tumors were located in the posterior portion of brain, however there was no singificant statistics due to small number of patients. Mean survival period for glioblastoma multiforme was 11.8 months in hyperfractionated group vs 8.7 months in conventional fractionated group and for high grade astrocytoma 36month in hyperfractionated group, but in conventional fractionated group all was died in 18 months. Acute radiation reaction occurred less frequently in hyperfractionated group, 15.8% vs 47.8% in conventional fractionated group(p<0.024). Alopeci was developed in 31.6% of the hyperfractionated group vs 82.6% of the conventional fractionated group(p<0.0031). One case of later radiation necrosis in cancer region was suspected in the hyperfractionated group but we has been in a dilemma for confirmatory diagnosis in present available diagnostic technique. The hyperfractionated irradiation technique was proven to be superior to conventional fractionated technique regarding the radiation reaction and the effectiveness of the treatment.
Astrocytoma ; Brain ; Brain Neoplasms ; Diagnosis ; Glioblastoma ; Glioma* ; Humans ; Necrosis ; Radiotherapy*