Nestin expression identifies ependymoma patients with poor outcome

Till Milde, Thomas Hielscher, Hendrik Witt, Marcel Kool, Stephen C. MacK, Hedwig E. Deubzer, Ina Oehme, Marco Lodrini, Axel Benner, Michael D. Taylor, Andreas Von Deimling, Andreas E. Kulozik, Stefan M. Pfister, Olaf Witt, Andrey Korshunov

Onderzoeksoutput: Bijdrage aan tijdschriftArtikelpeer review

37 Citaten (Scopus)


Ependymomas are primary brain tumors found throughout the central nervous system (CNS) in children and adults. Currently, many treatment protocols stratify grade I and II ependymomas as low-risk tumors, whereas grade III anaplastic ependymomas are considered high-risk tumors. The prognostic significance of World Health Organization (WHO) grade II or III, however, remains debated, and it is furthermore increasingly recognized that the pathologic differentiation between grades II and III is arbitrary in daily practice, thus resulting in imprecise risk stratification. Therefore, prognostic markers enabling more precise stratification to guide treatment decisions are urgently needed. An analysis of n = 379 tumor samples revealed that protein expression of nestin, a marker for neural stem and progenitor cells established as a routine staining in most neuropathology centers, is associated with poor outcome in intracranial ependymomas. Most importantly, nestin-positive grade II ependymomas have the same prognosis as grade III ependymomas. Multivariable analysis demonstrates that nestin positivity is an independent marker for poor progression-free survival (PFS) and overall survival (OS). Gene expression analysis for transcriptionally co-regulated genes revealed a strong association of developmental and epigenetic processes with nestin. In summary, our data implicate nestin as a useful novel marker for intracranial ependymoma risk stratification easily implementable in routine diagnostics.

Originele taal-2Engels
Pagina's (van-tot)848-860
Aantal pagina's13
TijdschriftBrain Pathology
Nummer van het tijdschrift6
StatusGepubliceerd - nov. 2012
Extern gepubliceerdJa


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