Clinical significance of the histological and molecular characteristics of ependymal tumors: a single institution case series from China
Clinical significance of the histological and molecular characteristics of ependymal tumors: a single institution case series from China
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室管膜肿瘤组织学和分子特征的临床意义：来自中国的单一机构病例系列
DOI：
10.1186/s12885-019-5877-9
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发表时间：
2019-07-19
期刊：
影响因子：
3.8
通讯作者：
Chen, Zhongping
中科院分区：
文献类型：
--
作者：
Xi, Shaoyan;Sai, Ke;Chen, Zhongping
背景：依赖性肿瘤是病理上明确的起源于颅内隔室或脊髓的内在肿瘤，儿童和成人均可发病。最近基于组织学和分子特征的室管膜瘤的综合分类能够对不同预后的患者进行亚组。然而，组织学和分子标记在中国室管膜瘤患者中的应用鲜有报道。我们旨在证明室管膜肿瘤的组织学特征、v-相对网状内皮增生病毒癌基因同源物A （RELA）融合物和其他分子特征的意义。方法采用常规病理切片回顾室管膜肿瘤的组织学特征，采用荧光原位杂交（FISH）和免疫组化（IHC）方法研究RELA融合和cyclind1 （CCND1）的扩增，以及组蛋白3赖氨酸27 （H3K27me3）的三甲基化表达。采用SPSS软件对数据进行分析。结果：细胞增生、异型性、微血管增生、坏死、有丝分裂和Ki-67指数升高与肿瘤分级密切相关。肿瘤位置、坏死、有丝分裂和Ki-67指数与室管膜瘤的生存有关，但Ki67是唯一独立的预后因素。此外，RELA融合多出现在小儿III级颅内室管膜瘤中，表明患者生存时间缩短，且与患者年龄、肿瘤分级、细胞类型、细胞异型性、坏死程度及颅内室管膜肿瘤Ki67指数密切相关，而H3K27me3的降低预示着室管膜肿瘤预后较差。结论中国患者室管膜肿瘤的组织学和分子特征有助于肿瘤分级和预后预测。
BackgroundEpendymal tumors are pathologically defined intrinsic neoplasms originating in the intracranial compartments or the spinal cord that affect both children and adults. The recently integrated classification of ependymomas based on both histological and molecular characteristics is capable of subgrouping patients with various prognoses. However, the application of histological and molecular markers in Chinese patients with ependymomas has rarely been reported. We aimed to demonstrate the significance of histological characteristics, the v-relavian reticuloendotheliosis viral oncogene homolog A (RELA) fusions and other molecular features in ependymal tumors.MethodsWe reviewed the histological characteristics of ependymal tumors using conventional pathological slides and investigate the RELA fusions and Cylclin D1 (CCND1) amplification by Fluorescence in situ hybridization (FISH) and trimethylation of histone 3 lysine 27 (H3K27me3) expression by immunohistochemistry (IHC) methods. SPSS software was used to analyze the data.ResultsWe demonstrated that hypercellularity, atypia, microvascular proliferation, necrosis, mitosis, and an elevated Ki-67 index, were tightly associated with an advanced tumor grade. Tumor location, necrosis, mitosis and the Ki-67 index were related to the survival of the ependymomas, but Ki67 was the only independent prognostic factor. Additionally, RELA fusions, mostly presented in pediatric grade III intracranial ependymomas, indicated decreased survival times of patients, and closely related to the patients’ age, tumor grade, cellularity, cellular atypia, necrosis and Ki67 index in the intracranial ependymal tumors, whereas reduction of H3K27me3 predicted the worse prognosis in ependymal tumors.ConclusionsHistological and molecular features facilitate tumor grading and prognostic predictions for ependymal tumors in Chinese patients.