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Prognostic significance of MRP5 immunohistochemical expression in glioblastoma

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Abstract

Introduction

Glioblastoma multiforme (GBM) is the most frequent malignant primary brain tumor in adults, exhibiting poor survival. The efficacy of chemotherapy is often limited by the development of multidrug resistance by the tumor cells. In the current study, we investigated the prognostic significance of the multidrug resistance protein 5 (MRP5) in patients with GBM.

Materials and methods

We retrospectively studied 33 patients with GBM treated with a combination of surgery, postoperative radiotherapy and adjuvant temozolomide chemotherapy. MRP5 protein expression was determined immunohistochemically and correlated with other prognostic factors and survival.

Results

The immunohistochemical expression of MRP5 was observed in 0–45% of tumor cells. Patients with MRP5 index >11% exhibited significantly worse survival compared to those with MRP5 index ≤11 (10.5 vs. 18 months, p = 0.0002). Patients with Ki-67 index lower than 30% had longer survival (15 vs. 11 months, p = 0.0084). Furthermore, patients with a gross total tumor excision had better survival (p = 0.016). No significant difference was observed between preoperative Karnofsky performance score, age, gender and survival. In multivariate analysis, MRP5 index and the extent of tumor resection were identified as factors with independent prognostic power.

Conclusion

The present results imply that MRP5 index may hold a prognostic role in patients with GBM.

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Authors and Affiliations

  1. Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece

    George A. Alexiou, Spyridon Voulgaris & George Fotakopoulos

  2. Department of Pathology, University Hospital of Ioannina, Ioannina, Greece

    Anna Goussia & Antigoni Ntoulia

  3. Department of Nuclear Medicine, University Hospital of Ioannina, Ioannina, Greece

    Andreas D. Fotopoulos

  4. Department of Radiology, University Hospital of Ioannina, Ioannina, Greece

    Anastasia Zikou & Maria I. Argyropoulou

  5. Department of Radiation Therapy, University Hospital of Ioannina, Ioannina, Greece

    Perikles Tsekeris

  6. Department of Neurology, Neurosurgical Institute, University Hospital of Ioannina, Ioannina, Greece

    Athanasios P. Kyritsis

  7. PO BOX 103, Neohoropoulo, 45500, Ioannina, Greece

    George A. Alexiou

Authors
  1. George A. Alexiou
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  2. Anna Goussia
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  3. Spyridon Voulgaris
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  4. Andreas D. Fotopoulos
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  5. George Fotakopoulos
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  7. Anastasia Zikou
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  8. Perikles Tsekeris
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  9. Maria I. Argyropoulou
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  10. Athanasios P. Kyritsis
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Correspondence to George A. Alexiou.

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Alexiou, G.A., Goussia, A., Voulgaris, S. et al. Prognostic significance of MRP5 immunohistochemical expression in glioblastoma. Cancer Chemother Pharmacol 69, 1387–1391 (2012). https://doi.org/10.1007/s00280-012-1832-z

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  • DOI: https://doi.org/10.1007/s00280-012-1832-z

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