The correlation between the histological features and clinical outcome remains poor in pediatric @entity9128 . We performed a retrospective study of a group of 31 @entity1 (diagnosed from 1985 to 1995) to assess prognostic implications of the current grading system, of histological and immunohistochemical features, and of ploidy status estimated by flow cytometry. Immunoexpression of a broad spectrum of antigens was evaluated, including @entity1758 , @entity4910 , glial and epithelial proteins (GFAP, EMA, cytokeratins), molecules involved in controlling apoptosis ( @entity588 , @entity522 / @entity522 ), and @entity876 oncoprotein. Univariate and multivariate statistical analyses were performed to evaluate the influence of each variable on both the progression free survival (PFS) and the overall survival (OS) with at least 7-year follow up. Although we showed a significant correlation between histological grade and prognosis, the current grading system failed in predicting outcome in nearly one third of individual cases. Problems with interpathologist reproducibility were also demonstrated. The extent of surgical resection was the only clinical factor that was associated with survival. Both the PFS and the OS were significantly decreased for the following pathological variables: increased cellularity (>300 nuclei per HPF), mitotic activity of >7 per 10 HPF, increased MIB-1 @entity894 ( @entity894 ), topoisomerase-IIalpha @entity894 , S-phase fraction, and @entity876 and @entity588 positivity. Increased @entity4910 @entity894 was demonstrated to have only a marginally significant impact on PFS. A flow chart modeling was further performed to formulate a scheme for discriminating of prognostic subgroups. Based on that, @entity876 immunopositivity and/or MIB-1 @entity894 of >5% (after subtotal resection) or MIB-1 @entity894 of >15% (after complete resection) were the strongest indicators of the @entity5 's @entity146 and of a poor prognosis of the disease. Foci of hypercellularity should be specifically looked for in @entity424 for assessing the immunohistochemical studies.

Pediatric XXXX : prognostic relevance of histological, immunohistochemical, and flow cytometric factors.

@entity9128 :: ('MESH:C531673', 'Disease') :: ['intracranial ependymomas'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity522 :: ('836', 'Gene') :: ['caspase-3', 'CPP32'] @entity588 :: ('596', 'Gene') :: ['bcl-2'] @entity894 :: ('MESH:C566784', 'Disease') :: ['labeling index', 'LI'] @entity146 :: ('MESH:D001523', 'Disease') :: ['aggressive behavior'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity424 :: ('MESH:D004806', 'Disease') :: ['ependymomas'] @entity4910 :: ('595', 'Gene') :: ['cyclin D1'] @entity876 :: ('7157', 'Gene') :: ['p53'] @entity1758 :: ('57534', 'Gene') :: ['MIB-1, topoisomerase-IIalpha']
@entity9128 :: (MESH:C531673,Disease) :: ['intracranial ependymomas']
