Izycka-Swieszewska Ewa
Katedry i Zakładu Patomorfologii Akademii Medycznej w Gdańsku.
Neurol Neurochir Pol. 2003 Jan-Feb;37(1):59-71.
The aim of the study was to characterize vascular stroma in glioblastoma (GB), to analyze its immunomorphological features, and to seek a relationship between patients' age and characteristics of the tumor microcirculation. Subjects in the study were 38 patients with GB, divided into two groups according to their age: group I--14 patients aged under 49 (from 32 to 49), and group II--24 patients over 50 years of age (51-78). Main types of vessels were specified: microvessels with normal morphology (capillaries, arterioles/venules), telangiectases, haemangioma--like forms, and microvascular proliferation types--simple and glomeruloid. An immunohistochemical analysis of the vascular stroma was performed with monoclonal antibodies against vWf and CD31, ASM, and Collagen IV (DAKO) to visualize the vessel wall components. The immunomorphological analysis was carried out for particular types of vessels separately. The vWf and ASM expression ratios--percentage of immunopositive area on 10 representative tumor fields under 100 x HPF--were assessed using a computer image analyzer. The incidence of some vessel types was dependent on the patients' age: in group I vascular--rich areas were more numerous, while in group II glomeruloid proliferation was more frequent--20/24-83.3% vs 8/14-57.1%. Immunoreactivity of the examined antigens was not related to the patients' age. The endothelial markers positivity was found within cells directly around the vascular lumen, and the reaction with vWf was more pronounced than CD31 reactivity. The most intense reactions were noted in proliferative changes of both types and in capillaries. ASM reactivity was found in abluminal cells within all types of vessels, most abundant in glomeruloid proliferation. ASM positivity was present also in some capillaries. Collagen IV staining revealed various abnormalities in the vascular basement membrane structure. No significant intergroup differences were found in the vWf and ASM expression ratios. However, in both groups the ASM expression ratio was significantly higher than that of vWf expression (p < 0.001).
Expression of the vascular wall antigens under study depends on the blood vessel type. The number of cells with smooth muscle phenotype is significantly higher than that of endothelial cells, especially within proliferative vascular changes. Microvascular changes intensity is higher in the older patient group.
本研究旨在对胶质母细胞瘤（GB）中的血管基质进行特征描述，分析其免疫形态学特征，并探寻患者年龄与肿瘤微循环特征之间的关系。研究对象为38例GB患者，根据年龄分为两组：第一组——14例年龄在49岁以下（32至49岁）的患者，第二组——24例年龄在50岁以上（51至78岁）的患者。明确了主要血管类型：形态正常的微血管（毛细血管、小动脉/小静脉）、毛细血管扩张、血管瘤样形态以及微血管增殖类型——单纯型和肾小球样型。使用抗vWf、CD31、ASM和胶原蛋白IV（DAKO）的单克隆抗体对血管基质进行免疫组化分析，以观察血管壁成分。对特定类型的血管分别进行免疫形态学分析。使用计算机图像分析仪评估vWf和ASM表达比率——在100倍高倍视野下10个代表性肿瘤区域的免疫阳性面积百分比。某些血管类型的发生率取决于患者年龄：在第一组中，富含血管的区域更多，而在第二组中，肾小球样增殖更为频繁——20/24 - 83.3%对8/14 - 57.1%。所检测抗原的免疫反应性与患者年龄无关。在内皮标记物阳性在血管腔周围的直接细胞内发现，并且与vWf的反应比CD31反应更明显。在两种类型的增殖性改变以及毛细血管中观察到最强烈的反应。在所有类型血管的无腔细胞中发现ASM反应性，在肾小球样增殖中最为丰富。ASM阳性也存在于一些毛细血管中。胶原蛋白IV染色显示血管基底膜结构存在各种异常。在vWf和ASM表达比率方面未发现显著的组间差异。然而，在两组中，ASM表达比率均显著高于vWf表达比率（p < 0.001）。
所研究的血管壁抗原的表达取决于血管类型。具有平滑肌表型的细胞数量显著高于内皮细胞数量，尤其是在增殖性血管改变中。老年患者组的微血管变化强度更高。
