Nuclear Factor-Kappa B in Gliomas as a Predictive Factor for Tumor Recurrence – A Clinicopathological Study

Abstract

BACKGROUND: Glioma is the most common primary malignant brain tumor. Nuclear factor κB (NF-κB) has emerged as a regulator of the malignant phenotype in glioma, and in particular glioblastoma multiforme, with clear relation to tumor size, recurrence, and invasiveness. AIM: The aim of the study was to study the analysis of NF-κB expression in gliomas of different histologic types and grades and its correlation with various clinicopathologic indicators. METHODS: One hundred and ten paraffin blocks of glioma cases classified according to WHO classification into 14 (12.7%) cases of Grade I pilocytic astrocytoma, 27 (24.5%) cases of Grade II gliomas, 26 (23.6%) cases of Grade III gliomas, and 43 (39.1%) cases of Grade IV glioblastoma. The correlations between immunostainings and clinicopathological parameters were analyzed statistically. RESULTS: Positive immunostaining for NF-κB was encountered in (64/110) 58.2% of gliomas. Statistical analysis revealed significant association between positive NF-κB expression and high histological grade (p < 0.001), recurrence of the tumors (p = 0.001), large tumor size (≥5 cm) (p < 0.001), histological subtypes (glioblastoma represented 51.6% of NF-κB positive cases, while pilocytic astrocytoma represented 1.6% of NF-κB positive cases) (p < 0.001) and age of the patient (≥40) (p = 0.039). CONCLUSIONS: A strong direct relation between NF-κB expression and the grade of glioma was observed. NF-κB expression behaves as a negative independent prognostic factor for the risk of tumor recurrence. Hence, inhibition of NF-κB may be a new therapeutic strategy to prevent recurrence of gliomas, particularly the high-grade type.