Drozynska E, Izycka-Swieszewska E, Niedzwiecki M, Balcerska A, Perek D, Wachowiak J
Department of Pediatric Hematology, Oncology and Endocrinology, Medical University of Gdansk, 80-210 Gdansk, Poland.
Neoplasma. 2006;53(3):247-52.
Seventy-four neuroblastoma patients were analyzed according to the clinical data including age, stage, bone metastases, primary tumor localization, tumor diameter, LDH, and serum ferritin. Histological examination of tumor specimens comprised calculation of proliferative index (PI) on slides stained with anti Ki-67 antibody and assessment of microvascular density (MVD) on anti-CD34 stained sections. Wide range of PI (1.5-79; median 37.8%) and MVD (41-385; median 172/mm2) values was observed. Significant relationship between higher PI and tumor diameter more than 5 cm (40.3 vs 37.2%) was found. Lower PI was found more frequently in stroma-rich tumors. Significantly higher median MVD was found in infant tumors and in smaller tumors <5 cm. Tendency to inverse relationship between PI and MVD was observed. The high values of both PI and MVD were found in some aggressive tumors in patients >1-year old. We evaluated the new parameter: proliferative-vascular index (PVI) as PVI=PIxMVD which ranged from 213-18333. Among eleven patients >1 year old, with PVI >7000, seven (64%) had a poor outcome within the mean period of 22 months. Our results suggest that the simultaneous estimation of proliferative activity and vascularity of neuroblastomas could be studied as a prognostic indicator. Further investigations are needed to confirm this finding.
根据年龄、分期、骨转移、原发肿瘤定位、肿瘤直径、乳酸脱氢酶（LDH）和血清铁蛋白等临床数据，对74例神经母细胞瘤患者进行了分析。肿瘤标本的组织学检查包括在抗Ki-67抗体染色的玻片上计算增殖指数（PI），以及在抗CD34染色切片上评估微血管密度（MVD）。观察到PI（1.5 - 79；中位数37.8%）和MVD（41 - 385；中位数172/mm²）值的范围很广。发现PI较高与肿瘤直径大于5 cm（40.3%对37.2%）之间存在显著关系。在富含基质的肿瘤中更频繁地发现较低的PI。在婴儿肿瘤和直径小于5 cm的较小肿瘤中发现中位数MVD显著更高。观察到PI与MVD之间存在负相关趋势。在一些1岁以上患者的侵袭性肿瘤中发现PI和MVD均较高。我们评估了新参数：增殖血管指数（PVI），其计算方式为PVI = PI×MVD，范围为213 - 18333。在11例1岁以上、PVI > 7000的患者中，7例（64%）在平均22个月的时间内预后不良。我们的结果表明，同时评估神经母细胞瘤的增殖活性和血管生成情况可作为一种预后指标进行研究。需要进一步的研究来证实这一发现。
