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恢复期患者脑胶质母细胞瘤组织中存在 SARS-CoV-2 的证据。

Evidence for residual SARS-CoV-2 in glioblastoma tissue of a convalescent patient.

机构信息

Department of Neurosurgery.

Medical Laboratory Center, General Hospital of the Central Command Theater of PLA, Wuhan, PR China.

出版信息

Neuroreport. 2021 Jun 9;32(9):771-775. doi: 10.1097/WNR.0000000000001654.

Abstract

Since coronavirus disease 2019 (COVID-19) swept all over the world, several studies have shown the susceptibility of a patient with cancer to COVID-19. In this case, the removed glioblastoma multiforme (GBM)-adjacent (GBM-A), GBM-peritumor and GBM-central (GBM-C) tissues from a convalescent patient of COVID-19, who also suffered from glioblastoma meanwhile, together with GBM-A and GBM tissues from a patient without COVID-19 history as negative controls, were used for RNA ISH, electron microscopy observing and immunohistochemical staining of ACE2 and the virus antigen (N protein). The results of RNA ISH, electron microscopy observing showed that SARS-CoV-2 directly infects some cells within human GBM tissues and SARS-CoV-2 in GBM-C tissue still exists even when it is cleared elsewhere. Immunohistochemical staining of ACE2 and N protein showed that the expressions of ACE2 are significantly higher in specimens, including GBM-C tissue from COVID-19 patient than other types of tissue. The unique phenomenon suggests that the surgical protection level should be upgraded even if the patient is in a convalescent period and the pharyngeal swab tests show negative results. Furthermore, more attention should be paid to confirm whether the shelter-like phenomenon happens in other malignancies due to the similar microenvironment and high expression of ACE2 in some malignancies.

摘要

自 2019 年冠状病毒病(COVID-19)在全球范围内肆虐以来,多项研究表明癌症患者易感染 COVID-19。在这种情况下,我们从一名 COVID-19 康复期合并胶质母细胞瘤(GBM)的患者中切除的 GBM 旁(GBM-A)、GBM 瘤周和 GBM 中央(GBM-C)组织,以及一名无 COVID-19 病史的患者的 GBM-A 和 GBM 组织作为阴性对照,进行 RNA 原位杂交、电子显微镜观察和 ACE2 及病毒抗原(N 蛋白)的免疫组织化学染色。RNA 原位杂交和电子显微镜观察结果表明,SARS-CoV-2 可直接感染人 GBM 组织中的某些细胞,而且即使在其他部位清除了 SARS-CoV-2,GBM-C 组织中仍存在 SARS-CoV-2。ACE2 和 N 蛋白的免疫组织化学染色表明,COVID-19 患者的 GBM-C 组织等标本中 ACE2 的表达明显高于其他类型的组织。这种独特的现象表明,即使患者处于康复期且咽拭子检测结果为阴性,也应升级手术防护水平。此外,由于某些恶性肿瘤的微环境相似且 ACE2 表达较高,应更加关注是否在其他恶性肿瘤中也存在类似的避难现象。

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