Bekki Hirofumi, Matsumoto Yoshihiro, Yoshimoto Masato, Ishihara Shin, Kawaguchi Kenichi, Yamamoto Hidetaka, Oda Yoshinao, Nakashima Yasuharu, Harimaya Katsumi
Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
Department of Anatomic Pathology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
Spine Surg Relat Res. 2022 Aug 23;7(1):36-41. doi: 10.22603/ssrr.2022-0063. eCollection 2023 Jan 27.
Tumor size is an important factor in determining the appropriate clinical management of intradural-extramedullary schwannoma. A tumor volume reduction may be achieved by conservative targeted therapy instead of invasive surgery if a molecular event related to tumor size is discovered. Insulin-like growth factor II messenger RNA-binding protein 3 (IMP3), an oncofetal tumor-associated antigen that is expected to be a target for immunotherapy, was focused on in this study.
The IMP3 status was assessed by immunohistochemistry in 64 samples of intradural-extramedullary schwannoma, and the correlation between IMP3 expression and tumor size was evaluated.
Immunohistochemically, high IMP3 expression was observed in ~85% of schwannomas. The maximum tumor diameter of the high IMP3 expression group was significantly larger than that of the low IMP3 expression group (34.3 mm vs 18.5 mm, =0.002). The receiver operating characteristic curve demonstrated that a maximum tumor diameter of 24 mm was a predictable factor for IMP3 expression (sensitivity, 0.7; 1-specificity, 0.2; area under the curve, 0.82).
Upregulated IMP3 expression was associated with large tumor size, suggesting a possible therapeutic approach.
肿瘤大小是决定硬膜内髓外神经鞘瘤适当临床治疗的重要因素。如果发现与肿瘤大小相关的分子事件,通过保守的靶向治疗而非侵入性手术可能实现肿瘤体积缩小。胰岛素样生长因子II信使核糖核酸结合蛋白3(IMP3)是一种癌胚肿瘤相关抗原,有望成为免疫治疗的靶点,本研究聚焦于此。
采用免疫组织化学方法评估64例硬膜内髓外神经鞘瘤样本中的IMP3状态,并评估IMP3表达与肿瘤大小之间的相关性。
免疫组织化学显示,约85%的神经鞘瘤中观察到IMP3高表达。IMP3高表达组的最大肿瘤直径显著大于IMP3低表达组(34.3毫米对18.5毫米,P=0.002)。受试者工作特征曲线表明,最大肿瘤直径24毫米是IMP3表达的一个可预测因素(敏感性,0.7;1-特异性,0.2;曲线下面积,0.82)。
IMP3表达上调与肿瘤体积大有关,提示了一种可能的治疗方法。