Expression of p53 and Prognosis in Children with Malignant Gliomas

The clinical and histologic features of high-grade gliomas in children are not always useful prognostic indicators. This study investigated the prognostic usefulness of evaluating gliomas in children for the presence of p53, a protein involved in numerous aspects of the life and death of a cell. Children with tumors that contained many p53-positive cells had a much poorer outcome than children with tumors that contained few or no p53-positive cells. High-grade astrocytomas are the largest group of primary central nervous system tumors and generally have a poor prognosis. 1 – 4 However, many studies have found that a young age is a favorable prognostic factor, 3 – 7 suggesting that malignant gliomas in children might differ biologically from similar lesions in older patients. 8 High-grade gliomas in adults arise through several distinct molecular pathways of tumorigenesis. So-called primary malignant gliomas, which typically affect older patients and have a histologic grade of IV (i.e., glioblastoma multiforme) 9 at diagnosis, commonly show amplification of the epidermal growth factor receptor gene ( EGFR ), 10 – 15 which encodes a tyrosine . . .