Biselli R, Ferlini C, Fattorossi A, Boldrini R, Bosman C
Italian Air Force, DASRS, Aerospace Medical Department, Pratica di Mare, Rome, Italy.
Cancer. 1996 Feb 15;77(4):778-84. doi: 10.1002/(sici)1097-0142(19960215)77:4<778::aid-cncr25>3.0.co;2-x.
Inflammatory myofibroblastic tumor or inflammatory pseudotumor is an uncommon lesion reported in various organs and believed to be a non-neoplastic reactive inflammatory condition. The concept of benign lesion has been recently challenged from both clinical demonstration of recurrence and cytogenetic evidence of acquired clonal chromosomal abnormality. Because DNA aneuploidy can be a useful marker for neoplasia, we analyzed nuclear DNA content of these lesions using flow cytometry.
In this study, inflammatory myofibroblastic tumors from nine children were examined retrospectively by evaluating clinicopathologic features and ploidy. DNA ploidy status was analyzed by flow cytometry in nuclei isolated from paraffin-embedded tumor tissues.
Three of the nine patients had local recurrence or distant metastases. Flow cytometric DNA analysis revealed five of the nine cases were diploid and four hyperdiploid (DNA indices 1.14, 1.16, 1.19, and 1.33). All lesions had a low S-phase fraction. Samples from the three subjects with clinical recurrence were all hyperdiploid.
The present data indicate that flow cytometry identifies aneuploidy (hyperdiploidy) in approximately half of the cases of inflammatory myofibroblastic tumors. This feature appears to reflect a more aggressive biologic behavior. In addition to the reported cytogenetic abnormalities, our data suggest that inflammatory myofibroblastic tumor, generally considered a benign reactive inflammatory process, may evolve as a distinct, potentially malignant, lesion. Therefore, flow cytometric DNA analysis is a suitable tool to provide the clinician with both diagnostic and prognostic information and to individuate the most feasible therapeutic approach.
炎性肌纤维母细胞瘤或炎性假瘤是一种在各个器官中报道的罕见病变，被认为是一种非肿瘤性反应性炎症状态。良性病变的概念最近受到了复发的临床证据和获得性克隆染色体异常的细胞遗传学证据的挑战。由于DNA非整倍体可能是肿瘤形成的一个有用标志物，我们使用流式细胞术分析了这些病变的核DNA含量。
在本研究中，对9名儿童的炎性肌纤维母细胞瘤进行回顾性检查，评估其临床病理特征和倍体情况。通过流式细胞术分析从石蜡包埋的肿瘤组织中分离出的细胞核中的DNA倍体状态。
9名患者中有3名出现局部复发或远处转移。流式细胞术DNA分析显示，9例中有5例为二倍体，4例为超二倍体（DNA指数分别为1.14、1.16、1.19和1.33）。所有病变的S期分数都很低。3例临床复发患者的样本均为超二倍体。
目前的数据表明，流式细胞术在大约一半的炎性肌纤维母细胞瘤病例中识别出非整倍体（超二倍体）。这一特征似乎反映了更具侵袭性的生物学行为。除了已报道的细胞遗传学异常外，我们的数据表明，通常被认为是良性反应性炎症过程的炎性肌纤维母细胞瘤可能会演变成一种独特的、潜在恶性的病变。因此，流式细胞术DNA分析是一种合适的工具，可为临床医生提供诊断和预后信息，并确定最可行的治疗方法。
