Intraoperative quantification of meningioma cell proliferation potential using rapid flow cytometry reveals intratumoral heterogeneity
Intraoperative quantification of meningioma cell proliferation potential using rapid flow cytometry reveals intratumoral heterogeneity
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DOI：
10.1002/cam4.2178
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发表时间：
2019-06-01
期刊：
影响因子：
4
通讯作者：
Matsui, Toru
中科院分区：
文献类型：
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作者：
Oya, Soichi;Yoshida, Shinsuke;Matsui, Toru
背景评价脑膜瘤增殖能力的标准取样方法尚未建立。方法对术中快速流式细胞术(IFC)在定量评价脑膜瘤细胞增殖能力中的作用及肿瘤内异质性进行前瞻性研究。增殖指数(PI)定义为染色体数目异常的非整倍体细胞与总细胞的比率。结果对50例患者的118份标本进行了分析。术后MiB-1标记指数(LI)与PI呈显著正相关(R=0.59P<；0.0001)。PI值越高，年增长率(AGR，cm(3)/y)越高(R=0.5，P=0.0002，26例)。AGR与PI在肿瘤内的分布呈正相关。高AGR组肿瘤中心或周边PI最高，低AGR组最高(P=0.039，n=20)。当PI值在中央或周边较高时(P=0.006，n=37)，软脑膜供血者更多见。结论快速IFC有可能成为MIB-1LI的替代物。脑膜瘤存在瘤内细胞增殖能力的异质性，并与肿瘤的生物学特性有关，如AGR和软膜供给器的发育。这一观察结果强调了抽样方法标准化的重要性，以准确估计脑膜瘤复发的风险。
Background Standard sampling methods to evaluate the proliferative ability of meningioma have not been established. Methods This prospective study was conducted to evaluate the effectiveness of intraoperative rapid flow cytometry (iFC) using raw samples for the quantitative assessment of proliferative ability in meningioma cells and to investigate intratumoral heterogeneity. Proliferation index (PI) was defined as the ratio of aneuploid cells with an abnormal number of chromosomes to the total cells. Results From 50 patients, 118 specimens were analyzed. There was a statistically significant correlation between the postoperative MIB-1 labeling index (LI) and PI (R = 0.59, P < 0.0001). A higher PI was correlated with a higher annual growth rate (AGR, cm(3)/y) (R = 0.50, P = 0.0002, 26 patients). AGR showed a correlation with the intratumoral distribution of PI. PI was the highest at the center or the peripheral section of the tumor in tumors with high AGR, whereas it was highest at the dural attachment in tumors with low AGR (P = 0.039, n = 20). Pial feeders were more frequently observed when PI was high in the center or in the peripheral section (P = 0.006, n = 37). Conclusions Rapid iFC may thus become a substitute for MIB-1 LI. Intratumoral heterogeneity of cellular proliferative potential exists in meningiomas and is related to tumor biological characteristics such as AGR and development of pial feeders. This observation underscores the importance of standardization in the sampling method to accurately estimate the risk of meningioma recurrence.