Clinicopathologic study of forty-four histologically pure supratentorial oligodendrogliomas.
Clinicopathologic study of forty-four histologically pure supratentorial oligodendrogliomas.
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DOI：
10.1053/adpa.2000.8124
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发表时间：
2000-08
影响因子：
2
通讯作者：
R. Prayson;D. S. Mohan;P. Song;J. Suh
中科院分区：
文献类型：
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作者：
R. Prayson;D. S. Mohan;P. Song;J. Suh
近年来很少有研究专门针对单纯的少突胶质细胞肿瘤。我们回顾性分析了19年（1974年至1993年）诊断的44例幕上少突胶质细胞瘤患者的临床病理特征。研究组包括44名患者（年龄范围，8至69岁;中位数，42岁），包括31名男性。31例（70%）初次切除的肿瘤为低级别，13例（30%）为高级别（间变性）。使用St Anne-Mayo星形细胞肿瘤标准，19例肿瘤（43%）为2级，17例（39%）为3级，8例（18%）为4级。初次切除时肿瘤的组织学特征包括显著的核仁（N = 18，41%）、血管增生（N = 9，20%）、坏死（N = 6，14%）和微囊变性（N = 23，52%）。22个肿瘤（50%）的细胞核异常分级为轻度，18个（41%）为中度，4个（9%）为显著。最高有丝分裂计数范围为0 - 10个有丝分裂像（MF）/10个高倍视野（HPF）（平均2.4）。12例患者（27%）有4个或更多的MF/10 HPF。初次手术包括10例患者的大体全切除，16例患者的次全切除，14例患者的活检。31例患者接受了辅助放疗，15例接受了化疗。MIB-1标记指数范围为0 - 42.3（中位数，1.2 [低级别肿瘤中位数，0.5;间变性肿瘤中位数，6.2]）。p53蛋白在43例阳性肿瘤中有18例阳性（41%）。总体而言，5年和10年生存率分别为71%和63%。整个组的中位随访时间为5.2年。年龄大于45岁（P = 0.02）、有丝分裂计数≥ 4 MF/10 HPF（P = 0.0004）、MIB-1标记指数45岁）或肿瘤细胞增殖率增加的患者预后一般较差。虽然高组织学分级的肿瘤通常生存率较低，但相关性无统计学意义。
Few studies in recent years have specifically focused on pure oligodendroglial neoplasms. We retrospectively reviewed the clinicopathologic features of 44 patients with supratentorial oligodendroglioma diagnosed over a 19-year period (1974 to 1993). The study group consisted of 44 patients (age range, 8 to 69 years; median, 42 years), including 31 males. Thirty-one initially resected tumors (70%) were low grade and 13 (30%) were high grade (anaplastic). Using the St Anne-Mayo criteria for astrocytic tumors, 19 tumors (43%) were grade 2, 17 (39%) were grade 3, and 8 were (18%) grade 4. Histologic features of the tumors at initial resection included prominent nucleoli (N = 18, 41%), vascular proliferation (N = 9, 20%), necrosis (N = 6, 14%), and microcystic degeneration (N = 23, 52%). Nuclear atypia was graded as mild in 22 tumors (50%), moderate in 18 (41%), and marked in four (9%). The highest mitosis counts ranged from 0 to 10 mitotic figures (MF)/10 high-power fields (HPF) (mean, 2.4). Twelve patients (27%) had four or more MF/10 HPF. Initial surgery included gross total resection in 10 patients, subtotal resection in 16 patients, and biopsy in 14 patients. Thirty-one patients received adjuvant radiotherapy and 15 received chemotherapy. MIB-1 labeling indices ranged from 0 to 42.3 (median, 1.2 [low grade tumor median, 0.5; anaplastic tumor median, 6.2]). p53 immunostaining was observed in 18 of 43 stained tumors (41%). Overall, 5- and 10-year survival rates were 71% and 63%, respectively. The entire group had a median follow-up of 5.2 years. Age greater than 45 years (P = .02), mitosis counts of > or =4 MF/10 HPF (P = .0004), and MIB-1 labeling indices 45 years) or patients with tumors with an increased rate of cell proliferation generally have a worse prognosis. Although tumors of high histologic grade generally have a worse survival, the correlation was not statistically significant.