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    Giant Cell Glioblastoma; Long-Term Survival, and Correlation With Usual Glioblastoma
    (JOURNAL NEUROLOGICAL SCIENCES, 2008) Midi, Ahmet; Belirgen, Muhittin; Sav, Aydin; Bozkurt, Suheyla; Midi, Ipek; Kilic, Tuerker
    Background: Giant cell glioblastoma (GCGB) is a rare tumor of the central nervous system and it accounts for only 1% of all intracranial tumors and 5% of glioblastomas. Objective: The aim of this study is to assess the histopathological and immunohistochemical findings and their correlation with survival time. Material-Method: We retrieved 23 consecutive GCGB specimens from a cohort of 650 glioblastoma cases and 24 usual glioblastoma cases with known survival information between 1995 and 2003. We used silver stain for reticulin framework, Ki-67, GFAP and CD45 as immunohistochemical stains. Results: GCGB accounts for 5% of all glioblastomas. The average survival is 31 and 16 months in GCGB and UGB respectively. There were significant differences between GCGB and UGB including the tumor infiltrating lymphocyte, perivascular lymphocyte, giant cell and oligodendroglia-like cells as histologic parameters. Presence of oligodendroglia-like cells was positively correlated with survival in GCGB. The parameters that were correlated with survival in UGB were younger age, high mitosis rate and a high Ki-67 proliferating index. Other parameters were not statistically significant in correlation with survival. Conclusion: GCGB had an overall longer survival rate than classical glioblastoma but the result was not statically significant.
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    Investigation of The Effect of Radiotherapy on The Proliferative Index (Ki-67) in Recurring Diffuse Glial Tumors
    (JOURNAL NEUROLOGICAL SCIENCES, 2011) Midi, Ahmet; Belirgen, Muhittin; Caglar, Hale; Sav, Aydin
    Introduction: Radiotherapy (RT) has various effects such as apoptosis stimulation, mitosis inhibition, mutagenic effect, chromosomal aberration and neoplastic transformation. Aim: The aim of this study was to investigate the effect of RT administered to diffuse glial tumors on the proliferation activity and mitotic activity of the tumor. Material-Method: An overall of 49 re-operated recurrent cases (16 cases had received postoperative RT while 33 cases did not receive RT) diagnosed as glial tumor were included in this study. The tumor cohort consisted of diffuse astrocytoma, oligodendroglioma and oligoastrocytomas. Ki-67 proliferating index, mitoses and grades of the primary and recurrent tumors were compared. Result: We found that the grades of recurrent tumors were lower than the grade during the first surgery in cases that had RT compared to those that had not. Similarly, Ki-67 was lower in cases that had received RT. We also noted suppressed mitotic activity in cases that had received RT.