Department of Pathology, Beth Israel Deaconess Medical Center, Boston, USA.
Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, USA.
J Neurooncol. 2019 Nov;145(2):349-355. doi: 10.1007/s11060-019-03302-z. Epub 2019 Sep 30.
Pediatric brain tumors are associated with high morbidity and mortality, in part due to insufficient understanding of tumor biology. With limited tissue allocation for research from surgical specimens, a key barrier to improving biological understanding, brain tumor autopsies have become an increasingly valuable resource. This study reviews the brain tumor autopsy practice at our institution and describes specific emerging research utilization patterns beyond the clinical autopsy report.
We performed a retrospective analysis of brain tumor autopsies at Boston Children's Hospital (BCH) between 2007 and 2017 and reviewed their consents, neuropathology reports and final diagnoses. We reviewed the method of tissue triaging for research consented autopsies (bioregistry, frozen and fresh tissue) and documented their specific uses.
Ninety-six deaths at BCH were due to brain tumors; 56 autopsies were performed (58.3%), of which 49 (87.5%) were consented for research. Tumor mapping was performed on all cases and tissue was allocated for DNA- and RNA-based sequencing studies (published and ongoing). Three tissue allocations with a postmortem interval of 8 h or less resulted in successful cell lines. Tissue from 14 autopsies was contributed to the National DIPG Registry.
Our institutional pediatric brain tumor autopsy clinical experience demonstrates the increased utility and wide utilization of autopsy-derived tissue for multiple types of research. These results support the increased efforts to obtain research consent for brain tumor autopsy and active collection of unfixed autopsy material in the molecular era.
儿科脑肿瘤的发病率和死亡率较高，部分原因是对肿瘤生物学的了解不足。由于从手术标本中获取研究用组织的数量有限，这是改善生物学认识的一个关键障碍，因此脑肿瘤尸检已成为一种越来越有价值的资源。本研究回顾了我们机构的脑肿瘤尸检实践，并描述了超出临床尸检报告的具体新兴研究利用模式。
我们对 2007 年至 2017 年间波士顿儿童医院（BCH）的脑肿瘤尸检进行了回顾性分析，并查阅了其同意书、神经病理学报告和最终诊断。我们审查了同意进行研究的尸检（生物登记、冷冻和新鲜组织）的组织分类方法，并记录了它们的具体用途。
BCH 有 96 例死亡是由于脑肿瘤引起的；进行了 56 例尸检（58.3%），其中 49 例（87.5%）同意进行研究。所有病例均进行了肿瘤绘图，并分配组织进行 DNA 和 RNA 测序研究（已发表和正在进行中）。3 例尸检组织在死后 8 小时或更短时间内成功建立了细胞系。14 例尸检的组织被捐赠给国家 DIPG 登记处。
我们机构的儿科脑肿瘤尸检临床经验表明，尸检衍生组织在多种类型的研究中具有更高的实用性和广泛的用途。这些结果支持在分子时代为脑肿瘤尸检获得研究同意书并积极收集未固定的尸检材料增加努力。
