Akhavan-Sigari Reza, Gaab Michael Robert, Rohde Veit, Abili Mehdi, Ostertag Helmut
Department of Neurosurgery, University Medical Center Göttingen, Georg-August-University Göttingen, Robert-Koch-Strasse 40, 37075, Göttingen, Germany,
Eur Spine J. 2014 Nov;23(11):2416-22. doi: 10.1007/s00586-014-3417-5. Epub 2014 Jun 15.
To clarify whether vascular endothelial growth factor receptor 2 (VEGFR2) and inducible nitric oxide synthase (iNOS) are involved in the angiogenesis and recurrence of spinal chordoma tissues and influence the overall survival.
All patients affected by a spinal chordoma surgically treated between 1986 and 2007 were reviewed. We examined the expression of VEGFR2 and iNOS with immunohistochemistry using a tissue microarray containing 120 chordoma samples. Local recurrence and overall survival (OS) were analyzed.
A series of 40 chordoma patients who underwent surgery for a total of 120 lesions (including 80 recurrent lesions) were identified (sacrum 77.5 %, lumbar spine 17.5 %, cervical/thoracic spine 5 %). Surgical margins were wide in 30 (75 %), marginal in 8 (20 %) and intralesional in 2 (5 %) patients. Median follow-up was 120 months. The 5- and 10-year OS of the entire series of patients was 78.6 and 30 %, respectively. There were five primary chordomas (12.5 %) with moderate and 35 (87.5 %) with strong expression of VEGFR-2. All recurrent spinal chordomas displayed strong expression of VEGFR-2. The expression of iNOS was predominately moderate to high in primary chordomas: There were 15 tumors (37.5 %) with moderate and 25 tumors (62.5 %) with strong expression. All recurrent chordomas displayed strong expression of iNOS.
The high expression of VEGFR-2 and iNOS affected the OS. The OS at 10 years was only 30 %.
阐明血管内皮生长因子受体2（VEGFR2）和诱导型一氧化氮合酶（iNOS）是否参与脊索瘤组织的血管生成和复发，并影响总生存期。
回顾了1986年至2007年间接受手术治疗的所有脊索瘤患者。我们使用包含120个脊索瘤样本的组织芯片，通过免疫组织化学检测VEGFR2和iNOS的表达。分析局部复发和总生存期（OS）。
确定了40例脊索瘤患者，共进行了120次手术（包括80次复发病变）（骶骨77.5%，腰椎17.5%，颈椎/胸椎5%）。30例（75%）患者手术切缘为广泛切除，8例（20%）为边缘切除，2例（5%）为病损内切除。中位随访时间为120个月。整个系列患者的5年和10年总生存率分别为78.6%和30%。有5例原发性脊索瘤（12.5%）VEGFR-2表达为中度，35例（87.5%）为强表达。所有复发性脊索瘤均显示VEGFR-2强表达。原发性脊索瘤中iNOS的表达主要为中度至高表达：15例肿瘤（37.5%）为中度表达，25例肿瘤（62.5%）为强表达。所有复发性脊索瘤均显示iNOS强表达。
VEGFR-2和iNOS的高表达影响总生存期。10年总生存率仅为30%。
