Division of Oncology, Department of Pediatrics College of Medicine, Brain Tumor Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA.
Division of Hematology/Oncology, Department of Pediatrics, IWK Health Centre and Dalhousie University, Halifax, Nova Scotia, Canada.
J Neurooncol. 2021 Mar;152(1):107-114. doi: 10.1007/s11060-020-03679-2. Epub 2021 Jan 27.
While autopsy-repository programs with a variety of pediatric central nervous system (CNS) tumor types are a critical resource for preclinical neuro-oncology research, few exist and there is no published guidance on how to develop one. The goal of this prospective Pediatric Brain Tumor Repository (PBTR) study was to develop such a program at Cincinnati Children's Hospital Medical Center (CCHMC) and then publish the quantitative and experiential data as a guide to support the development of similar programs.
Protocols and infrastructure were established-to educate oncologists and families, establish eligibility, obtain consent, address pre- and post-autopsy logistics (e.g., patient and tissue transportation), process and authenticate tissue samples, and collect and analyze data.
Of the 129 pediatric CNS tumor patients at CCHMC who died between 2013 and 2018, 109 were eligible for our study. Of these, 74% (81 of 109) were approached for PBTR donation, and 68% (55 of 81) consented. In the final year of the study, approach and consent rates were 93% and 85%, respectively. Median time from death to autopsy (postmortem interval, PMI) was 10 h (range, 1.5-30). In the outpatient setting, PMI increased with distance (from the hospice/home where the patient died to CCHMC). In all patients, PMI appeared to be lower, when consent was obtained more than 24 h before death.
Procurement of autopsy specimens need not be a barrier in neuro-oncology research. Regional centers, strict timing-of-consent, patient education, and dedicated staff are all needed to minimize PMI and, thereby, increase the value of the procured tissue for an array of basic and translational research applications.
虽然具有各种儿科中枢神经系统 (CNS) 肿瘤类型的尸检存储库程序是临床前神经肿瘤学研究的重要资源，但此类程序很少，并且没有关于如何开发此类程序的公开指南。本前瞻性小儿脑瘤存储库 (PBTR) 研究的目标是在辛辛那提儿童医院医疗中心 (CCHMC) 开发此类程序，然后发布定量和经验数据作为支持类似程序开发的指南。
建立了方案和基础设施-教育肿瘤学家和家属，确定资格，获得同意，解决尸检前后的后勤问题（例如，患者和组织运输），处理和验证组织样本，并收集和分析数据。
在 2013 年至 2018 年期间在 CCHMC 去世的 129 名儿科 CNS 肿瘤患者中，有 109 名符合我们的研究条件。其中，74%（109 名中的 81 名）被提议捐赠 PBTR，68%（81 名中的 55 名）同意。在研究的最后一年，接近率和同意率分别为 93%和 85%。从死亡到尸检的中位时间（死后间隔，PMI）为 10 小时（范围为 1.5-30 小时）。在门诊环境中，PMI 随距离（从患者死亡的临终关怀/家到 CCHMC）而增加。在所有患者中，当同意在死亡前超过 24 小时获得时，PMI 似乎较低。
尸检标本的获取不一定是神经肿瘤学研究的障碍。区域中心、严格的同意时间、患者教育和专门的工作人员都是减少 PMI 所必需的，从而增加了所获取组织的价值，适用于一系列基础和转化研究应用。
