{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T07:33:07Z","timestamp":1772609587626,"version":"3.50.1"},"reference-count":37,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T00:00:00Z","timestamp":1624838400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2021,5,20]]},"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      An ependymoma shows divergent morphological and molecular features depending on their location. The paired box 6 (\n                      <jats:italic>PAX6<\/jats:italic>\n                      ) transcription factor is a putative tumour suppressor and drives cancer cells towards a stem cell-like state. A transcriptome study reported high\n                      <jats:italic>PAX6<\/jats:italic>\n                      expression in ependymal tumours, but data on protein expression are lacking.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We, therefore, analysed\n                      <jats:italic>PAX6<\/jats:italic>\n                      expression by immunohistochemistry in 172 ependymoma samples and correlated its expression to histology, WHO grade, anatomical location and molecular subgroups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean\n                      <jats:italic>PAX6<\/jats:italic>\n                      nuclear expression in ependymoma was 27.5% (95% CI 23.3 to 31.7).\n                      <jats:italic>PAX6<\/jats:italic>\n                      expression in subependymoma (mean: 5%) was significantly lower compared with myxopapillary (30%), WHO grade II (26%) and anaplastic ependymoma (35%). Supratentorial ependymomas also displayed significant lower\n                      <jats:italic>PAX6<\/jats:italic>\n                      levels (15%) compared with spinal cord tumours (30%). Expression levels in YAP1-fused ependymoma (41%) were higher compared with REL-associated protein (RELA)-fusion positive tumours (17%), while\n                      <jats:italic>PAX6<\/jats:italic>\n                      expression was similar in posterior fossa group A (33%) and B (29%) ependymomas. Kaplan-Meier analysis in RELA-fusion positive ependymomas and posterior fossa group B showed a significant better outcome for\n                      <jats:italic>PAX6<\/jats:italic>\n                      at or above the cut-off of 19.45% compared with tumours with\n                      <jats:italic>PAX6<\/jats:italic>\n                      below the cut-off.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      We demonstrate that\n                      <jats:italic>PAX6<\/jats:italic>\n                      is frequently expressed in human ependymal tumours and immunohistochemistry may be helpful in determining prognostic relevant subgroups.\n                    <\/jats:p>\n                  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