Department of Pathomorphology, Medical University of Gdansk, Poland.
Folia Neuropathol. 2011;49(2):94-102.
Ependymal tumours are relatively uncommon primary neoplasms of the central nervous system. Histological criteria distinguishing ependymoma and anaplastic ependymoma are not clear-cut and other parameters are required to allow more precise prognostication in these tumours. We analysed the histological and immunohistochemical features of these tumours (Ki-67, cyclin D1, EGFR, hTERT, Olig2) and correlated them with the clinical outcome.
We analysed 39 patients with grade II ependymoma (30) and anaplastic ependymoma (9). Twenty-eight tumours developed in children and the remaining 11 patients were adults with intracranial and intraspinal tumours. Eighteen patients died during the follow-up period.
Overall survival was reduced significantly for paediatric patients and patients with intracranial tumour. High-grade tumours, increased mitotic index and increased cellularity had an unfavourable influence on survival. Other histological parameters such as nuclear atypia, necrosis and microvascular proliferation did not alter the survival rate. Increased Ki-67 and cyclin D1 indices correlated with worse prognosis. Furthermore, any level of cyclin D1 expression in WHO grade II ependymomas was strongly associated with higher risk of death. No correlation was identified between Olig2, EGFR and hTERT expression and the outcome of the patients.
室管膜瘤是中枢神经系统相对少见的原发性肿瘤。区分室管膜瘤和间变室管膜瘤的组织学标准并不明确，需要其他参数来更准确地预测这些肿瘤的预后。我们分析了这些肿瘤的组织学和免疫组织化学特征（Ki-67、cyclin D1、EGFR、hTERT、Olig2），并将其与临床结果相关联。
我们分析了 39 例 2 级室管膜瘤（30 例）和间变室管膜瘤（9 例）患者。28 例肿瘤发生在儿童，其余 11 例患者为颅内和脊髓内肿瘤的成年人。18 例患者在随访期间死亡。
儿童患者和颅内肿瘤患者的总生存率显著降低。高级别肿瘤、有丝分裂指数增加和细胞增多对生存率有不利影响。其他组织学参数，如核异型性、坏死和微血管增生，并没有改变生存率。Ki-67 和 cyclin D1 指数的增加与预后不良相关。此外，在 WHO 2 级室管膜瘤中，任何 cyclin D1 表达水平都与更高的死亡风险强烈相关。Olig2、EGFR 和 hTERT 表达与患者的预后之间没有相关性。
