Tumor Infiltration in Enhancing and Non-Enhancing Parts of Glioblastoma: A Correlation with Histopathology.
Tumor Infiltration in Enhancing and Non-Enhancing Parts of Glioblastoma: A Correlation with Histopathology.
复制标题
在增强胶质母细胞瘤的增强和非增强部分的肿瘤浸润：与组织病理学的相关性。
DOI：
10.1371/journal.pone.0169292
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Radbruch A
中科院分区：
文献类型：
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作者：
Eidel O;Burth S;Neumann JO;Kieslich PJ;Sahm F;Jungk C;Kickingereder P;Bickelhaupt S;Mundiyanapurath S;Bäumer P;Wick W;Schlemmer HP;Kiening K;Unterberg A;Bendszus M;Radbruch A
将活检标本的组织病理学结果与对比增强T1加权MRI扫描（cT 1）上增强区、非增强区和坏死区内的相应位置相关联。在37例接受立体定向活检的新诊断胶质母细胞瘤患者中，我们获得了561个1 mm 3活检标本与1.5特斯拉术中cT 1图像上相应位置的相关性。将活检点分类为cT 1上的增强（CE）、非增强（NE）或坏死（NEC），并将组织样本分类为“活肿瘤细胞”、“血液”或“坏死组织（有或无细胞成分）"。半自动进行细胞计数。NE具有分类为活肿瘤细胞的组织的最高含量（分别为89%与CE中的60%和NEC中的30%）。此外，NE的平均细胞密度（3764 ± 2893个细胞/mm 2）与CE（3506 ± 3116个细胞/mm 2）相当，而NEC的细胞密度较低，为2713 ± 3239个细胞/mm 2。如果排除坏死部分和出血，则活检中归类为“活肿瘤组织”的细胞密度从肿瘤中心（NEC，5804 ± 3480个细胞/mm 2）降低至CE（4495 ± 3209个细胞/mm 2）和NE（4130 ± 2817个细胞/mm 2）。胶质母细胞瘤在cT 1图像上的表现（环形增强，中央坏死，瘤周水肿）与其弥漫性组织病理学组成不一致。CE和NE部分的细胞密度均升高。因此，我们的研究表明，NE含有相当数量的浸润性肿瘤，细胞密度高，可能会考虑在切除计划。
To correlate histopathologic findings from biopsy specimens with their corresponding location within enhancing areas, non-enhancing areas and necrotic areas on contrast enhanced T1-weighted MRI scans (cT1). In 37 patients with newly diagnosed glioblastoma who underwent stereotactic biopsy, we obtained a correlation of 561 1mm3 biopsy specimens with their corresponding position on the intraoperative cT1 image at 1.5 Tesla. Biopsy points were categorized as enhancing (CE), non-enhancing (NE) or necrotic (NEC) on cT1 and tissue samples were categorized as “viable tumor cells”, “blood” or “necrotic tissue (with or without cellular component)”. Cell counting was done semi-automatically. NE had the highest content of tissue categorized as viable tumor cells (89% vs. 60% in CE and 30% NEC, respectively). Besides, the average cell density for NE (3764 ± 2893 cells/mm2) was comparable to CE (3506 ± 3116 cells/mm2), while NEC had a lower cell density with 2713 ± 3239 cells/mm2. If necrotic parts and bleeds were excluded, cell density in biopsies categorized as “viable tumor tissue” decreased from the center of the tumor (NEC, 5804 ± 3480 cells/mm2) to CE (4495 ± 3209 cells/mm2) and NE (4130 ± 2817 cells/mm2). The appearance of a glioblastoma on a cT1 image (circular enhancement, central necrosis, peritumoral edema) does not correspond to its diffuse histopathological composition. Cell density is elevated in both CE and NE parts. Hence, our study suggests that NE contains considerable amounts of infiltrative tumor with a high cellularity which might be considered in resection planning.