Paulus W, Jänisch W
Institut für Hirnforschung, Universität Tübingen, Federal Republic of Germany.
Acta Neuropathol. 1990;80(6):635-41. doi: 10.1007/BF00307632.
Sixty-seven tumor specimens of epithelial choroid plexus neoplasms obtained by 60 biopsies and 7 autopsies from 52 patients were investigated. Diagnoses of the first operations were choroid plexus papilloma (PP; 32 cases), choroid plexus papilloma with histological atypies (atypical PP; 6 cases), and choroid plexus carcinoma (PC; 14 cases). Carcinoembryonic antigen was expressed by 2 of the 3 biopsies autoptically recognized as metastatic carcinomas and by 2 autopsy cases of PC, while it was absent in all biopsies of true choroid plexus tumors. Tumor cells positive for transthyretin (TTR, prealbumin), S-100 protein (S100), and glial fibrillary acidic protein (GFAP) were detected in 39, 46 and 13, respectively, of the 49 cases of true choroid plexus tumors. Fourth ventricle tumors expressed more S100 (number of positive tumor cells) than lateral ventricle tumors, PP more S100 and TTR than atypical PP/PC. Tumors from patients 20 years of age and older expressed more GFAP and TTR than tumors from younger patients. Of the 30 patients with complete follow-up 19 were alive 2 to 11 years after surgery, including 7 recurrencies. Eleven died from the tumor 4 months to 7 years after surgery. The following histopathologic features (in order of decreasing significance) were correlated with poor prognosis (recurrency or fatal outcome): less than 50% of the tumor cells heavily positive for S100, presence of mitoses, absence of TTR-positive cells, brain invasion by cell nests, absence of marked stromal edema, and presence of necrotic areas. Our results indicate that some histologic features correlate significantly with poor prognosis and that immunohistochemical results correlate with tumor localization, age, and malignancy.
对52例患者通过60次活检和7次尸检获得的67份上皮性脉络丛肿瘤标本进行了研究。首次手术的诊断为脉络丛乳头状瘤（PP；32例）、伴有组织学异型性的脉络丛乳头状瘤（非典型PP；6例）和脉络丛癌（PC；14例）。在3例经尸检确认为转移性癌的活检标本及2例PC尸检病例中检测到癌胚抗原，而在所有真正的脉络丛肿瘤活检标本中均未检测到。在49例真正的脉络丛肿瘤中，分别有39例、46例和13例检测到转甲状腺素蛋白（TTR，前白蛋白）、S-100蛋白（S100）和胶质纤维酸性蛋白（GFAP）呈阳性的肿瘤细胞。第四脑室肿瘤比侧脑室肿瘤表达更多的S100（阳性肿瘤细胞数量），PP比非典型PP/PC表达更多的S100和TTR。20岁及以上患者的肿瘤比年轻患者的肿瘤表达更多的GFAP和TTR。在30例有完整随访资料的患者中，19例术后2至11年存活，其中7例复发。11例患者术后4个月至7年死于肿瘤。以下组织病理学特征（按重要性递减顺序）与预后不良（复发或致命结局）相关：S100重度阳性的肿瘤细胞少于50%、有丝分裂的存在、无TTR阳性细胞、细胞巢侵犯脑实质、无明显的间质水肿以及存在坏死区域。我们的结果表明，一些组织学特征与预后不良显著相关，免疫组化结果与肿瘤定位、年龄和恶性程度相关。
