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Mitotic percentage index: A new prognostic factor for childhood medulloblastoma

Lookup NU author(s): Dr Richard Gilbertson, Dr Evelyn Jaros, Emeritus Professor Robert Perry, Professor John LunecORCiD, Professor Andrew Pearson


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We investigated the prognostic significance of a new method of mitotic figure quantitation, 'mitotic percentage index' (MPI), tumour S phase fraction (SPF) and DNA ploidy measured by flow cytometry, and various clinical prognostic factors including age, sex, tumour stage, degree of surgical resection, radiotherapy dose and adjuvant chemotherapy in 70 cases of childhood medulloblastoma diagnosed between 1968 and 1996. In univariate analysis, MPI (P < 0.0001), posterior fossa radiotherapy dose (P = 0.003), tumour stage (P = 0.014), craniospinal radiotherapy dose (P = 0.019), year of diagnosis (P = 0.024) and SPF (P = 0.048) were significantly related to survival. In multivariate analysis, including tumour c-erbB-2 oncogene product expression, only MPI (P < 0.0001), craniospinal radiotherapy dose (P = 0.003) and tumour stage (P = 0.035) retained independent prognostic significance, while age achieved significance (P = 0.039). A close relationship was observed between MPI and SPF (coeff = 0.8, P < 0.0001) and MPI and the percentage of turnour cells expressing the c-erbB-2 oncogene product (coeff = 0.416, P < 0.0001). This study has identified MPI as a new independent prognostic factor for childhood medulloblastoma. Its close relationship with tumour SPF confirms it as an accurate measure of tumour proliferation and its close relationship to expression of the c-erbB-2 oncogene supports a role for this growth factor receptor in the deregulation of normal mitogenic signal transduction in this malignancy.

Publication metadata

Author(s): Gilbertson R, Jaros E, Perry R, Kelly P, Lunec J, Pearson A

Publication type: Article

Publication status: Published

Journal: European Journal of Cancer Part A

Year: 1997

Volume: 33

Issue: 4

Pages: 609-615

Print publication date: 01/04/1997

ISSN (print): 0959-8049

ISSN (electronic): 1879-0852


DOI: 10.1016/S0959-8049(96)00516-3

PubMed id: 9274443


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