Pathogenesis of intracranial germ cell tumors reconsidered.
Pathogenesis of intracranial germ cell tumors reconsidered.
复制标题
重新考虑颅内生殖细胞肿瘤的发病机制。
DOI：
10.3171/foc.1998.5.1.4
复制
发表时间：
1998
影响因子：
4.1
通讯作者：
K. Sano
中科院分区：
文献类型：
--
作者：
K. Sano
对象
为了确定颅内生殖细胞肿瘤（GCT）的发病机制，作者研究了 1994 年遇到的 153 例此类肿瘤，其中 62.7% 表现出单型组织学模式，其中 37.3% 表现出混合肿瘤。
方法
六名患者入院后不久死亡并接受尸检；其他患者接受手术后进行放射和/或化疗。截至 1997 年底，对 134 例病例进行了随访。所有绒毛膜癌患者均在一年内死亡。患有卵黄囊肿瘤（内胚窦肿瘤）或胚胎癌的患者预后也很差。患有成熟畸胎瘤的患者的 5 年和 10 年生存率分别为 93%。未成熟畸胎瘤患者的 5 年和 10 年生存率分别为 86%，而畸胎瘤恶变患者的 3 年生存率为 50%。生殖细胞瘤患者的 5 年生存率为 96%，10 年生存率为 93%。这些结果可能会让人质疑生殖细胞理论的有效性，因为根据该理论，生殖细胞瘤应该是最未分化的肿瘤，但根据后续研究的结果，绒毛膜癌和卵黄囊肿瘤（内胚窦肿瘤）是最恶性的，而根据该理论，绒毛膜癌和卵黄囊肿瘤（内胚窦肿瘤）是最恶性的。
结论
除生殖细胞瘤外，生殖细胞肿瘤可能并非源自一种单一类型的细胞（原始生殖细胞）。胚胎发生各阶段的胚胎细胞可能在原条形成时错位在双层胚盘中，参与外侧中胚层流，并被带到神经板区域，在神经管形成时错误地卷入大脑。作者提出以下假设：由与胚胎发生早期（个体发生）出现的细胞类似的细胞组成的肿瘤，比由与胚胎发生后期出现的细胞类似的细胞组成的肿瘤恶性程度更高。
OBJECT
To determine the pathogenesis of intracranial germ cell tumors (GCTs), the author studied 153 cases of these tumors encountered through 1994, 62.7% of which showed monotypic histological patterns and 37.3% of which were shown to be mixed tumors.
METHODS
Six patients died soon after admission and underwent autopsy; the other patients underwent surgery followed by radio- and/or chemotherapy. One hundred thirty-four cases were followed through the end of 1997. All patients with a choriocarcinoma died within 1 year. Patients with a yolk sac tumor (endodermal sinus tumor) or an embryonal carcinoma also had poor outcomes. Patients with a mature teratoma had 5- and 10-year survival rates of 93% each. Patients with an immature teratoma had 5- and 10-year survival rates of 86% each, whereas patients who had a teratoma with malignant transformation had a 3-year survival rate of 50%. Patients with a germinoma had a 5-year survival rate of 96% and a 10-year survival rate of 93%. These results may bring into question the validity of the germ cell theory because germinoma, which should be the most undifferentiated tumor according to the theory, was the most benign and choriocarcinoma and yolk sac tumor (endodermal sinus tumor), which should be the most differentiated tumors, were the most malignant according to results obtained during the follow-up study.
CONCLUSIONS
Germ cell tumors other than germinomas may not originate from one single type of cell (primordial germ cells). The embryonic cells of various stages of embryogenesis may perhaps be misplaced in the bilaminar embryonic disc at the time of the primitive streak formation, becoming involved in the stream of lateral mesoderm and carried to the neural plate area to become incorrectly enfolded into the brain at the time of neural tube formation. The author propounds the following hypothesis: tumors composed of cells resembling the cells that appear in the earlier stages of embryogenesis (ontogenesis) are more malignant than those composed of cells resembling the cells that appear in the later stages of embryogenesis.
少突胶质细胞中 K 电流的表达和调节：在髓鞘形成中的可能作用。
影响因子：
2.9
作者：
Soliven,B;Szuchet,S;Arnason,BG;Nelson,DJ
通讯作者：
Nelson,DJ