Ashkan K, Casey A T, D'Arrigo C, Harkness W F, Thomas D G
Departments of Neurological Surgery and Neuropathology, National Hospital for Neurology and Neurosurgery, London, England.
Cancer. 2000 Sep 1;89(5):1111-20.
"Central neurocytoma" is classically considered as an intraventricular benign tumor, largely based on data from small retrospective series. The authors present prospective data on 12 patients with tumors diagnosed as central neurocytoma, to highlight the diverse nature of this tumor and challenge the classic notion.
Between 1991 and 1997, 12 patients had tumors diagnosed prospectively as "central neurocytoma". Clinical, radiologic, and histologic data were collected, and Karnofsky performance score was evaluated for each patient. Proliferation marker studies were performed using Ki-67 labeling index.
In two patients, the tumors were located in atypical locations, namely, the parietal lobe and the spine. Aggressive behavior characterized by clinical and radiologic evidence of tumor progression was noted in two additional patients. In both these cases, unusually high proliferation rates of 5.3% and 11.2% were noted. Total excision of the tumor, when possible, was the treatment of choice. Postoperative radiotherapy to the residual tumor may be of benefit in patients with clinically aggressive tumors, or those with high proliferation rates.
Given the findings of this study, it is suggested that the traditional concept of central neurocytoma as a benign intraventricular tumor warrants reconsideration.
“中枢神经细胞瘤”传统上被视为一种脑室内良性肿瘤,这主要基于小型回顾性系列研究的数据。作者展示了12例被诊断为中枢神经细胞瘤患者的前瞻性数据,以突出该肿瘤的多样性并挑战传统观念。
1991年至1997年间,12例患者的肿瘤被前瞻性诊断为“中枢神经细胞瘤”。收集了临床、放射学和组织学数据,并对每位患者评估了卡氏功能状态评分。使用Ki-67标记指数进行增殖标志物研究。
2例患者的肿瘤位于非典型部位,即顶叶和脊柱。另外2例患者表现出以肿瘤进展的临床和放射学证据为特征的侵袭性行为。在这两例中,均观察到异常高的增殖率,分别为5.3%和11.2%。在可能的情况下,肿瘤全切是首选治疗方法。对于具有临床侵袭性肿瘤或高增殖率的患者,对残留肿瘤进行术后放疗可能有益。
鉴于本研究的结果,提示将中枢神经细胞瘤视为脑室内良性肿瘤的传统观念值得重新审视。