Salmaggi A, Gelati M, Pollo B, Marras C, Silvani A, Balestrini M R, Eoli M, Fariselli L, Broggi G, Boiardi A
Istituto Nazionale Neurologico C.Besta, Via Celoria 11, 20133 Milano, Italy.
J Neurooncol. 2005 Sep;74(3):287-93. doi: 10.1007/s11060-004-7327-y.
The clinical course of 50 patients with low-grade glioma (31 male, 19 female) undergoing surgery at a single Institution from 1992 to 1996 was analyzed in relationship with known prognostic factors as far as time to tumor progression (TTP) and survival time (ST) are concerned. Moreover, microvessel density (MVD) and expression of the angiogenesis-related chemokine CXCL12 were investigated in surgical specimens. Age at diagnosis ranged from 1 to 68 years (median 30). Histology revealed 11 fibrillary, 6 protoplasmatic, 5 gemistocytic astrocytoma, 18 oligoastrocytoma and 10 oligodendroglioma. Mean follow-up was 86 months. Four patients were lost to follow-up. Of the remaining 46, twenty-four have shown disease progression and 14 have died. Median overall survival was not achieved; an estimated 75% percentage of survivors was found at 78 months. Complete gross tumor removal was associated to a longer TTP (P = 0.04 logrank). Of the investigated immunohistochemical parameters, while MVD was not predictive of subsequent TTP, expression of CXCL12 was associated with a significantly shorter TTP (P = 0.01 logrank): this predictive value remained significant (P = 0.02) at multivariate analysis. The data suggest the possible prognostic value for CXCL-12 (an angiogenesis- and tumor-growth-related chemokine) on TTP in low-grade gliomas.
分析了1992年至1996年在单一机构接受手术的50例低级别胶质瘤患者(31例男性,19例女性)的临床病程,涉及到与已知预后因素相关的肿瘤进展时间(TTP)和生存时间(ST)。此外,还研究了手术标本中的微血管密度(MVD)和血管生成相关趋化因子CXCL12的表达。诊断时的年龄范围为1至68岁(中位数为30岁)。组织学检查显示有11例纤维型、6例原浆型、5例肥胖型星形细胞瘤,18例少突星形细胞瘤和10例少突胶质细胞瘤。平均随访时间为86个月。4例患者失访。在其余46例中,24例出现疾病进展,14例死亡。未达到总体生存中位数;在78个月时发现估计75%的幸存者。肿瘤全切与更长的TTP相关(P = 0.04,对数秩检验)。在所研究的免疫组化参数中,虽然MVD不能预测随后的TTP,但CXCL12的表达与显著更短的TTP相关(P = 0.01,对数秩检验):在多变量分析中,这种预测价值仍然显著(P = 0.02)。数据表明CXCL-12(一种与血管生成和肿瘤生长相关的趋化因子)对低级别胶质瘤TTP可能具有预后价值。