Wang Rui-Fen, Guan Wen-Bin, Yan Yu, Jiang Bo, Ma Jie, Jiang Ma-Wei, Wang Li-Feng
Department of Pathology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Pediatric Neurosurgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Pathology. 2016 Oct;48(6):555-63. doi: 10.1016/j.pathol.2016.05.010. Epub 2016 Aug 21.
Atypical teratoid/rhabdoid tumours (AT/RTs) are rare, highly malignant tumours of the central nervous system (CNS) with poor prognosis that usually affect young children. The aim of this study was to assess the clinicopathological features and prognostic factors of AT/RTs. Here, we describe the clinicopathological and immunohistochemical characteristics, along with the treatments and outcomes, of 22 patients with AT/RTs treated in our hospital from 2010 to 2015. Morphologically, cytoplasmic vacuoles, the most common characteristic in our cases, were observed in 68% of the cases. Similarly, vesicular nuclei were detected in 68% of the cases. However, rhabdoid cells were found in only 59.1% of the cases and were not observed in 40.9% of the cases. Immunohistochemical analysis revealed loss of nuclear INI1 expression in all 22 cases. Age, surgical resection and adjuvant therapy, but not tumour location, were associated with AT/RTs patient prognosis. Our results showed that cells with cytoplasmic vacuoles or with vesicular nuclei are more common than rhabdoid cells in patients with AT/RTs and that a lack of INI1 protein expression is the most useful marker for the differential diagnosis of AT/RTs. Young age is a negative prognostic factor, whereas gross total surgical resection and adjuvant therapy are positive prognostic factors for AT/RT patients.
非典型畸胎样/横纹肌样肿瘤(AT/RTs)是中枢神经系统(CNS)罕见的高度恶性肿瘤,预后较差,通常影响幼儿。本研究的目的是评估AT/RTs的临床病理特征和预后因素。在此,我们描述了2010年至2015年在我院接受治疗的22例AT/RTs患者的临床病理、免疫组化特征以及治疗和结局。形态学上,胞质空泡是我们病例中最常见的特征,68%的病例观察到这一特征。同样,68%的病例检测到泡状核。然而,仅59.1%的病例发现横纹肌样细胞,40.9%的病例未观察到。免疫组化分析显示所有22例病例均有核INI1表达缺失。年龄、手术切除和辅助治疗与AT/RTs患者的预后相关,而肿瘤位置无关。我们的结果表明,在AT/RTs患者中,有胞质空泡或泡状核的细胞比横纹肌样细胞更常见,并且INI1蛋白表达缺失是AT/RTs鉴别诊断最有用的标志物。年轻是一个负面预后因素,而手术全切和辅助治疗是AT/RTs患者的正面预后因素。