Korshunov Andrey, Golanov Andrey, Sycheva Regina, Timirgaz Valery
Department of Neuropathology, Burdenko Neurosurgical Institute, Moscow, Russia.
Cancer. 2004 Mar 15;100(6):1230-7. doi: 10.1002/cncr.20075.
Ependymomas account for 3-5% of all intracranial malignancies and occur most often in children and young adults. These neoplasms continue to generate considerable controversy with regard to their rational clinical management. It has been shown that the histologic classification of ependymoma is a significant predictor of clinical outcome in patients with ependymoma.
Ependymomas from 258 patients who underwent microsurgery at a single institution were evaluated histologically to elucidate the prognostic utility of a recently proposed grading scheme. Pathologic and clinical data then were compared using univariate and multivariate analyses.
Increasing grade of ependymoma malignancy was found to be associated strongly and independently with worse clinical outcomes in terms of both event-free survival and overall survival. The effect of radiotherapy also was found to be related to histologic grade and was more beneficial for patients who had anaplastic ependymomas and had undergone complete tumor removal.
The application of a uniform diagnostic criteria for grading ependymomas highlighted the key role of tumor histology in clinical outcome in a cohort of patients who were treated in the microsurgical era. The recently proposed grading scheme is likely to be practically useful, reproducible, and clinically applicable.
室管膜瘤占所有颅内恶性肿瘤的3% - 5%，最常发生于儿童和青年。这些肿瘤在合理的临床管理方面仍存在相当大的争议。已表明室管膜瘤的组织学分类是室管膜瘤患者临床结局的重要预测指标。
对在单一机构接受显微手术的258例患者的室管膜瘤进行组织学评估，以阐明最近提出的分级方案的预后效用。然后使用单变量和多变量分析比较病理和临床数据。
发现室管膜瘤恶性程度增加与无事件生存期和总生存期方面更差的临床结局密切且独立相关。还发现放疗的效果与组织学分级有关，对间变性室管膜瘤且肿瘤完全切除的患者更有益。
应用统一的室管膜瘤分级诊断标准突出了肿瘤组织学在显微手术时代接受治疗的一组患者临床结局中的关键作用。最近提出的分级方案可能具有实际用途、可重复性且临床适用。
