Maiuri F, Del Basso De Caro M, Siciliano A, Peca C, Vergara P, Mariniello G, Pettinato G
Department of Neurological Sciences, Section of Neurosurgery, School of Medicine, University Federico II, Naples, Italy.
Clin Neuropathol. 2010 Mar-Apr;29(2):109-14. doi: 10.5414/npp29109.
The aim of this study is to evaluate the correlation between the expression of some growth factors (GFs) and the tumor grade, recurrence and survival of brain glial and ependymal tumors.
The expression of vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), tenascine, transforming growth factor (TGFbeta), isomeres, platelet-derived growth factor (PDGF) and p53 was studied in 40 primary brain tumors, both low-grade and high-grade, including astrocytomas, oligodendrogliomas, glioblastomas and ependymomas. The same GFs were also studied in 46 specimens of recurrent tumors from the same patients. The positivity and intensity of the immunohistochemical expression were correlated with the tumor grade, the interval and type of recurrence, and the survival.
The expression of all GFs, excepting TGFbeta1, TGFbetaRI and tenascine, was found to be correlated with the tumor grade in all tumors of both astroglial and oligodendroglial origin, whereas ependymomas showed significant differences only for EGFR. Low-grade (Grade II) tumors recurring as anaplastic (Grade III) forms showed GF expression rather similar to initially high-grade gliomas and significantly higher than that of low-grade (Grade II) tumors in both initial surgery and recurrence. Besides, low-grade (Grade II) tumors recurring as low-grade showed significantly longer median recurrence time (5.4 vs. 3.5 years) and better median survival (8.3 vs. 5.4 years) than those recurring as anaplastic forms (WHO III).
The immunohistochemical study of expression of VEGF, EGFR, TGFbeta2, TGFbeta3, PDGF and p53 in all low-grade (Grade II) brain gliomas at the first operation may help to differentiate cases with slower evolution and longer survival from those with higher potential of anaplastic transformation.
本研究旨在评估某些生长因子（GFs）的表达与脑胶质和室管膜肿瘤的肿瘤分级、复发及生存之间的相关性。
研究了40例原发性脑肿瘤（包括低级别和高级别肿瘤，如星形细胞瘤、少突胶质细胞瘤、胶质母细胞瘤和室管膜瘤）中血管内皮生长因子（VEGF）、表皮生长因子受体（EGFR）、腱生蛋白、转化生长因子（TGFβ）异构体、血小板衍生生长因子（PDGF）和p53的表达。还对同一患者的46例复发性肿瘤标本进行了相同生长因子的研究。免疫组化表达的阳性率和强度与肿瘤分级、复发间隔和类型以及生存情况相关。
在星形胶质细胞和少突胶质细胞起源的所有肿瘤中，除TGFβ1、TGFβRI和腱生蛋白外所有生长因子的表达均与肿瘤分级相关，而室管膜瘤仅在EGFR方面表现出显著差异。低级别（II级）肿瘤复发为间变性（III级）形式时，其生长因子表达与最初的高级别胶质瘤相当相似，且在初次手术和复发时均显著高于低级别（II级）肿瘤。此外，低级别（II级）肿瘤复发为低级别时，其复发中位时间（5.4年对3.5年）显著更长，中位生存期（8.3年对5.4年）也比复发为间变性形式（WHO III级）的肿瘤更好。
首次手术时对所有低级别（II级）脑胶质瘤中VEGF、EGFR、TGFβ2、TGFβ3、PDGF和p53表达进行免疫组化研究，可能有助于区分进展较慢、生存期较长的病例与间变性转化潜力较高的病例。
