Cai Xu, Qin Jun-Jie, Hao Shu-Yu, Li Huan, Zeng Chun, Sun Sheng-Jun, Yu Lan-Bing, Gao Zhi-Xian, Xie Jian
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Brain Tumor, Beijing, China.
Department of Neuropathology, Beijing Neurosurgical Institute, Beijing, China.
Clin Neurol Neurosurg. 2018 Mar;166:141-146. doi: 10.1016/j.clineuro.2018.01.038. Epub 2018 Feb 1.
Glioma is the most common malignant tumor of the brain and the intracranial dissemination of gliomas is the late stage of the development of the tumor. However, there is little research in literature on the occurrence of intracranial dissemination of gliomas. In order to provide a reference for clinical work, we carried out this study on intracranial dissemination of glioma.
A total of 629 patients with gliomas received tumor resection by the same surgeon from August 2010 to September 2015 were included in this study. The authors performed a retrospective review of the patients and the information regarding clinical features, histopathological results, molecular pathologic results and clinical outcomes was collected and analyzed.
In this retrospective study, we found that the intracranial dissemination phenomenon occurred in 53 patients (8.43%). We analyzed the clinical characteristics of patients and found that the age at diagnosis (P = 0.011), WHO grade of the tumor (P < 0.001), and involvement of the corpus callosum (P = 0.010) were associated with the occurrence of dissemination. The higher grade of the tumor, the more prone to disseminate. Deletion of 1p/19q had no significant correlation with the intracranial dissemination. MMP9, Ki-67, and EGFR were highly expressed in tumor cells that caused dissemination, and the level of Ki-67 expression had significance in statistics (P < 0.01).
In our study, older age (>40 years), high pathological grade, invasion of the corpus callosum and high levels of Ki-67 expression were risk factors associated with the intracranial dissemination of gliomas.
胶质瘤是最常见的脑恶性肿瘤，胶质瘤的颅内播散是肿瘤发展的晚期阶段。然而，文献中关于胶质瘤颅内播散发生情况的研究较少。为给临床工作提供参考，我们开展了这项关于胶质瘤颅内播散的研究。
本研究纳入了2010年8月至2015年9月期间由同一位外科医生进行肿瘤切除的629例胶质瘤患者。作者对患者进行了回顾性分析，收集并分析了有关临床特征、组织病理学结果、分子病理学结果及临床结局的信息。
在这项回顾性研究中，我们发现53例患者（8.43%）出现了颅内播散现象。我们分析了患者的临床特征，发现诊断时的年龄（P = 0.011）、肿瘤的世界卫生组织分级（P < 0.001）以及胼胝体受累情况（P = 0.010）与播散的发生相关。肿瘤分级越高，越容易发生播散。1p/19q缺失与颅内播散无显著相关性。基质金属蛋白酶9（MMP9）、Ki-67和表皮生长因子受体（EGFR）在导致播散的肿瘤细胞中高表达，且Ki-67表达水平具有统计学意义（P < 0.01）。
在我们的研究中，年龄较大（>40岁）、病理分级高、胼胝体受侵以及Ki-67高表达水平是与胶质瘤颅内播散相关的危险因素。
