Abstract
Abstract: :
Purpose: To study the expression pattern of proliferative index by Ki 67LI, metastasis suppressor protein nm23 H1, nm23 H2 gene products and apoptosis related protein CD95 (APO-1/FAS) in aggressive retinoblastomas. (Rb) Methods: Formalin fixed and paraffin embedded tissue sections of 76 cases of Rb included. Rb was divided in 3 groups. Group A (21 cases): Intraocular Rb. Group B (46 cases): Rb with choroidal, optic nerve, orbit invasion and orbital recurrence. Group C (9 cases)): Rb with metastasis, death and poor response to chemotherapy. Expression of Ki 67 LI, nm23 H1, nm 23 H2 and CD95 studied using specific monoclonal antibodies. Rb was divided in to 3 groups based on Ki 67 LI and the staining pattern of nm23 H1 nm23 H2, and CD95. Group 1: ≷50% Ki 67 LI / intense stain, Group II: 10-50% Ki 67LI / weak staining Group III: <10% Ki 67LI / negative staining. Data was analyzed for statistical significance Results: Group A: 13 cases showed high Ki 67 LI, 6 showed moderate Ki 67 LI and 2 very low for Ki 67 LI (P value 0.012). nm 23 H1, nm23 H2 staining intense in 16 cases, weak in 3 and negative in 2 cases (P value <0.001). CD95 staining intense in 13, weak in 4 and negative in 4 cases (P value 0.025). Group B: High Ki 67 LI seen in 10, moderate Ki 67 LI in 16 and very low Ki 67LI seen in 20 cases (P value 0.199). nm 23 H1, nm23 H2 staining intense in 7, weak in 17 and negative in 22 cases (P value 0.020). CD95 staining intense in 2, weak in 1 and negative in 43 cases (P value<0.001). Group C: High Ki 67 LI seen in 1 case, moderate Ki 67 LI in 2 and very low KI 67 LI seen in 6 cases (P value NS). nm 23 H1, nm23 H2 intense staining not seen, weak staining in 1 and negative staining in 8 cases (P value <0.001). Intense staining for CD95 negative, weak staining seen in 1 and negative staining seen in 8 cases (P value 0.001). Conclusion: Reduced expression of nm 23 H1, nm23 H2, CD 95 expression could serve as an additional independent markers in evaluating the choroidal, orbital invasion and metastasis in Rb. Ki 67 LI is paradoxically low in aggressive Rb. We are not able to explain this finding. CR: None
Keywords: 569 retinoblastoma • 610 tumors • 496 oncology