2. Service of epidemiology (Epidemiological Survillance Service). National Institute of Respiratory disease (INER). México city México, Calzada de Tlalpan 4502, colonia sección XVI. Delegación Tlalpan cp. 14080, México.
3. Resident of Neurology. National Institute of Neurology and Neurosurgery, "Manuel Velasco Suárez", Av Insurgentes Sur 3877 Col. La Joya, Delegación Tlalpan CP 14269, México.
Background: Ependymoma is a tumor that formed from the ependyma. Usually, in paediatric cases the location is intracranial, while in adults it is spinal.
Methods: We study the prognostic implications of the current grading system, of histological and immunohistochemical features of GFAP, GFAP-δ, EMA, neurofilament and E-cadherin expression and Ki-67 in ependymomas.
Results: 60 cases were included in this study of which 32 were female and 28 were male, aging ranged from 18 to 65 years old (mean age of 34.18±11.35 yr). 17 were supratentorial, 25 infratentorial and 18 cases were spinal location. Histologically 15 were grade 1, 36 were grade II and 9 grade III. 23 cases recurrence (4, 13 and 6 stage III respectively), with mean age 34.52±12.23 years vs 33.97±97.94 that not recurrence. The expression of GFAP-δ was negative in 38 cases and positive in 21(p=0.359). GFAP-δ expression was correlated with anaplastic type (grade III). Tumor grade and tumor size, brain invasion, atypia, and mitosis features and also were correlated with higher expression of neurofilament, higher ki- 67-Li, as well as loss of immnunoexpression of E-Cadherina and EMA.
Conclusions: PGAF, S-100, and GFAP-δ expression in ependymomas varied and depends of the histologic grade likewise the value of proliferation index. The expression of GFAP-δ was in directly relationship with presence of neurofilament and loss of E-Cadherins and EMA expression. Studies have suggested that human ependimomas arise from regionally distinct populations of radial glial cells.
Keywords: E-cadherin, ependymoma, immunohistochemistry, GFAP-δ, Ki-67