Glioblastoma Multiforme and Angiogenesis: A Clinicopathological and Immunohistochemistry Approach

Abstract

Background: Glioblastomas multiforme (GBMs) are histologically heterogeneous tumors derived from highly vascularized glia. This microvascular proliferation is a biological key to diagnosis. Methods: The purpose of this study was to analyze the immunohistochemistry features of these lesions, looking for commonly expressed antibodies such as vimentin, nestin, glial fibrillary acidic protein (GFAP), GFAP delta (GFAP-δ), vascular endothelial growth factor (VEGF), VEGF receptor 2 (VEGF-R2), VIII factor, CD31, CD34 and CD15 in 80 cases of GBM patients with a 15-month follow-up. Microvascular density (MVD) and Ki-67 labeling index (LI) were performed. Results: Eighty patients’ GBMs were surgically removed in 1 year with a 15-month follow-up, including 64 men (80%) and 16 women (20%). The age range was 37 - 87 years (mean age 58.36 ± 9.929 years). Seventeen (21%) cases were less than 50 years old (P = 0.003). The range of age in men was 37 - 71 years (median age 56 years) and in women was 39 - 86 years (median age 58 years). Thirty-five (44%) cases had secondary tumors and 45 (56%) had primary tumors. Survival time ranged between 14 and 60 weeks (mean 44.40 ± 16.26 weeks). Inflammation and necrosis were more common in primary than in secondary, also with one showing higher MVD index for VEGF, VEGF-R2, CD31 and CD34. Conclusion: Expression of nestin, vimentin, GFAP-δ, VEGF, and VEGF-R2 peritumoral cells has bad prognosis in GBM. J Neurol Res. 2015;5(3):199-206 doi: http://dx.doi.org/10.14740/jnr337w