Arslantas Ali, Artan Sevilhan, Oner Ulkü, Durmaz Ramazan, Müslümanoğlu Hamza, Atasoy Metin Ant, Başaran Nurettin, Tel Eşref
Department of Neurosurgery, University of Osmangazi, Eskisehir, Turkey.
Acta Neurol Belg. 2002 Jun;102(2):53-62.
Meningiomas are common tumors of the central nervous system. Although most are benign tumors, approximately 10% show a histologic progression to a higher malignancy grade similar to atypical (GII) and anaplastic (GIII) meningiomas. Monosomy 22q12 is the most frequent genetic alteration detected in these tumors, but failure of detection of 22q mutations in about 40% of tumors which are indistinguishable from meningiomas with 22q deletions with respect to clinical and histopathologic features, makes it apparent that an alternative mechanism is responsible for the initiation of meningioma. Moreover, little is known about genetic alterations during malignant progression of meningioma.
In order to determine the genetic pathways underlying the development of meningioma, 15 benign (WHO grade I), 7 atypical (WHO grade II) and 3 anaplastic (WHO grade III), sporadic meningiomas were screened by Comparative Genomic Hybridization (CGH).
Statistical analysis revealed a significant correlation between the number of chromosomal imbalances and the tumor grade; the numbers of total alterations detected per tumor were 2.20 (2.24 for GI, 10.00 (1.17 for GII and 14.66 (1.15 for GIII. The most frequent abnormality seen in benign tumors was loss on 22q (47%). The second alteration was 1p deletion (33%) and this abnormality was also the common aberration in three tumors without CGH detected 22q deletion. In GII, aberrations most commonly identified were losses on 1p (6/7 cases), 22q (5/7 cases), 10q (4/7 cases), 14q and 18q (3/7 cases) as well as gains on 15q and 17q (3/7 cases). In GIII, genomic loss on 1p was the most commonly observed abnormality (3/3). Losses on 9p, 10q, 14q, 15q, 18q and 22q as well as gains on 12q, 15q and 18p were the other genomic alterations detected by CGH. Combined 1p/14q deletions were encountered in 2/15 benign, 3/7 atypical and 2/3 anaplastic meningiomas. By CGH, DNA sequences on 17q21-qter were seen to be amplified in 1/7 GII and 2/3 GIII, whereas highly amplified DNA sequences on 12q13-qter, 20q and 22q11-q12 were seen in one GII, two GII/one GIII, and one GIII, respectively.
It was concluded that chromosomal deletion from 1p could play a major role in the initiation and progression of meningiomas and that 1p/14q deletions could be a primary focus of further detailed assessment of tumour genesis.
脑膜瘤是中枢神经系统常见肿瘤。虽然大多数是良性肿瘤,但约10%会出现组织学进展,发展为更高恶性等级,类似于非典型(II级)和间变性(III级)脑膜瘤。22号染色体长臂12区单体性是这些肿瘤中最常见的基因改变,但约40%的肿瘤在临床和组织病理学特征上与存在22q缺失的脑膜瘤无法区分,却未检测到22q突变,这表明存在另一种机制导致脑膜瘤的发生。此外,对于脑膜瘤恶性进展过程中的基因改变知之甚少。
为了确定脑膜瘤发生发展的基因途径,采用比较基因组杂交(CGH)技术对15例良性(世界卫生组织I级)、7例非典型(世界卫生组织II级)和3例间变性(世界卫生组织III级)散发性脑膜瘤进行筛查。
统计分析显示染色体不平衡数量与肿瘤分级之间存在显著相关性;每个肿瘤检测到的总改变数分别为:I级2.20(2.24)、II级10.00(1.17)和III级14.66(1.15)。良性肿瘤中最常见的异常是22q缺失(47%)。第二种改变是1p缺失(33%),这种异常也是3例未检测到22q缺失的肿瘤中的常见畸变。在II级肿瘤中,最常见的畸变是1p缺失(6/7例)、22q缺失(5/7例)、10q缺失(4/7例)、14q和18q缺失(3/7例)以及15q和17q增益(3/7例)。在III级肿瘤中,1p基因组缺失是最常见的异常(3/3)。CGH检测到的其他基因组改变包括9p、10q、14q、15q、18q和22q缺失以及12q、15q和18p增益。1p/14q联合缺失在2/15例良性、3/7例非典型和2/3例间变性脑膜瘤中出现。通过CGH发现,17q21 - qter上的DNA序列在1/7例II级和2/3例III级肿瘤中扩增,而12q13 - qter、20q和22q11 - q12上的高度扩增DNA序列分别在1例II级、2例II级/1例III级和1例III级肿瘤中出现。
得出结论,1p染色体缺失可能在脑膜瘤的发生和进展中起主要作用,1p/14q缺失可能是肿瘤发生进一步详细评估的主要焦点。