Prognostic significance of neuronal marker expression in glioblastomas
Prognostic significance of neuronal marker expression in glioblastomas
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DOI：
10.1007/s00381-012-1883-9
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发表时间：
2012-11-01
影响因子：
1.4
通讯作者：
Lee, Min-Cheol
中科院分区：
文献类型：
--
作者：
Lee, Kyung-Hwa;Kang, Kyung-Joo;Lee, Min-Cheol
胶质母细胞瘤是中枢神经系统肿瘤中恶性程度最高的肿瘤，其生物学异质性众所周知。与胶质母细胞瘤中纯胶质分化的假定假设相反，它们通常表现出神经元标记物的免疫阳性。然而，其神经元标志物表达的意义仍有争议。为了评估神经元表达在胶质母细胞瘤中的预后意义，本研究调查了大量胶质母细胞瘤患者中神经元标记物的表达，并采用免疫组织化学方法对88例胶质母细胞瘤中突触素、神经丝蛋白和NeuN的表达进行了研究。根据免疫阳性病例比较临床病理变量以及患者的生存数据，88个肿瘤中的61个（69.3%）至少一种神经元标记物阳性。突触体素阳性43例（48.9%）.神经丝蛋白阳性38例（43.2%），NeuN阳性42例（47.7%）.总生存期和无进展生存期与神经元标志物表达无统计学显著差异。然而，大体全切除或联合放疗和化疗显着延长生存期（P = 0.041和0.044）。考克斯的比例风险模型显示NeuN表达是无进展生存期的独立预后因素（P = 0.012），尽管神经元标记物表达与胶质母细胞瘤临床预后的相关性是相当有趣的，但现有数据支持神经元标记物表达在胶质母细胞瘤中的有限预后价值。
Glioblastomas are the most malignant tumors of central nervous system neoplasms and are well known for their biological heterogeneity. Contrary to the putative hypothesis of purely glial differentiation in glioblastomas, they often demonstrate immunopositivity for neuronal markers. However, the significance of their neuronal marker expression is still controversial. To evaluate the prognostic implication of neuronal expression in glioblastoma, this study investigated the expression of neuronal markers in a large series of glioblastoma patients in terms of patient survival rate.Expression of synaptophysin, neurofilament protein, and NeuN was explored using immunohistochemistry in 88 cases of glioblastoma. Clinicopathological variables as well as patients' survival data were compared according to the immunopositivity of cases.Sixty-one of the 88 tumors (69.3 %) were positive for at least one neuronal marker. Synaptophysin positivity was observed in 43 cases (48.9 %). Neurofilament protein and NeuN were positive in 38 (43.2 %) and 42 cases (47.7 %), respectively. There was no statistically significant difference in overall survival and progression-free survival in association with neuronal marker expression. However, gross total removal or combined radiotherapy and chemotherapy significantly prolonged survival (P = 0.041 and 0.044). Cox's proportional hazard model revealed that NeuN expression was the independent prognostic factors in progression-free survival (P = 0.012).Although the correlation of neuronal marker expression and clinical outcome in glioblastoma is of considerable interest, the presented data support the limited prognostic value of neuronal marker expression in glioblastoma.