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目的 拟找出与各级星形细胞瘤的预后相关的因素。方法 收集解放军总医院病理科1987～ 1996年间归档的颅内各级星形细胞瘤 ,选择其中经手术全切、术后正规放疗且资料基本齐全的12 0例 (其中 94例有随访资料 )。同时选取尸检正常脑组织、脱髓鞘病变组织共 2 0份作为对照。应用免疫组织化学方法检测石蜡标本中Ki 6 7、血管内皮生长因子 (VEGF)、TRT蛋白的表达 ,用Ⅳ型胶原标记微血管 ,并用原位杂交方法检测TRTmRNA和端粒酶RNA的表达 ,对所得的各项指标进行统计分析。结果 (1)Ki 6 7在肿瘤和脱髓鞘病变呈多少不等的阳性 ,不同级别及与非肿瘤组织之间差异有显著性。多元回归分析显示该指标是预后的独立危险因素之一 ,以 8.5 %为分界点两条生存曲线间时序分析差异有显著性 (P <0 .0 1)。 (2 )微血管密度 :Ⅰ、Ⅱ级与正常脑组织胶质细胞之间的微血管密度差异无显著性 ,而Ⅲ、Ⅳ级微血管数均显著增多 (P <0 .0 1) ,坏死组织中微血管平均数较Ⅲ、Ⅳ级更为增多 ,VEGF的表达与微血管密度呈显著性相关 (P <0 .0 1)。 (3)端粒酶反转录酶蛋白在正常胶质细胞中呈阴性 ,在增生病例和Ⅰ、Ⅱ、Ⅲ、Ⅳ级肿瘤病变中呈现阳性率和阳性强度递增的现象 ,它与分级和预后相关 (P <0 .0 1) ;端粒酶反转录酶mRNA和端粒酶RNA的表?
Objective To identify factors related to the prognosis of astrocytoma at all levels. Methods A total of astrocytomas were collected from Department of Pathology, People’s Liberation Army General Hospital from 1987 to 1996. Among them, 120 cases were selected after undergoing surgical resection and regular postoperative radiotherapy and data were basically complete (94 of them had follow-up data). At the same time, 20 normal brain tissue and demyelinated lesions were selected as controls. Immunohistochemistry was used to detect the expression of Ki 67, vascular endothelial growth factor (VEGF) and TRT protein in paraffin specimens, label microvessels with type IV collagen, and detect the expression of TRT mRNA and telomerase RNA by in situ hybridization. The indicators for statistical analysis. RESULTS: (1) The Ki 67 level in tumors and demyelinating lesions was different, and the difference between different grades and non-tumor tissues was significant. Multiple regression analysis showed that the index was one of the independent risk factors for prognosis, and the difference between the two survival curves at the cutoff point of 8.5% was significant (P < 0.01). (2) Microvessel density: There was no significant difference in microvessel density between grade I and grade II and normal brain tissue glial cells, while the number of microvessels in grades III and IV was significantly increased (P < 0.01). Microvessels in necrotic tissue The average number was higher than that of grades III and IV. The expression of VEGF was significantly correlated with microvessel density (P < 0.01). (3) The telomerase reverse transcriptase protein was negative in normal glial cells and showed a positive rate and a positive intensity increase in cases of hyperplasia and grade I, II, III, and IV tumors. It was associated with grading and prognosis. Correlation (P < 0.01); telomerase reverse transcriptase mRNA and telomerase RNA expression?