Kim D G, Kim J S, Chi J G, Park S H, Jung H W, Choi K S, Han D H
Department of Neurosurgery, Seoul National University College of Medicine, Korea.
J Neurosurg. 1996 May;84(5):742-7. doi: 10.3171/jns.1996.84.5.0742.
The authors analyzed 13 central neurocytomas diagnosed at Seoul National University Hospital between January 1982 and December 1993 to clarify the proliferative potential and biological behavior of these tumors. The tumor was confined to the lateral and third ventricles in 12 cases and in one case extended from the posterior thalamus to the body and trigone area of the lateral ventricle. In all 13 cases, typical clinical and radiological findings were observed, and histological diagnosis was performed via craniotomy. The diagnosis was made using light microscopic examination, immunohistochemical staining for neuronal markers, and electron microscopic findings of neuronal differentiation. One patient died due to tumor progression with recurrence 26 months after subtotal removal plus radiation therapy. Another patient had a recurrence 18 months after total tumor removal. The remaining 11 patients are free of recurrent tumor after a follow-up period that ranged from 14 to 109 months (median 50 months). To predict the proliferative potential, immunoreactivity to proliferating cell nuclear antigen (PCNA), silver colloid staining for nucleolar organizing regions (AgNORs), and DNA flow cytometry were performed in 10 of the 13 cases. The proportion of PCNA-positive cells was less than 1% in all cases and the AgNORs score ranged from 1.11 to 2.0 (mean 1.67). The DNA flow cytometry revealed diploidy in all cases and the calculated proliferation index ranged from 5.1% to 9.6% (mean 7.8%). The one case of tumor recurrence, in which the authors performed the study of proliferative potential, and another case that demonstrated mild nuclear pleomorphism also showed low percentages of PCNA-positive cells, low AgNORs scores, and diploidy in DNA flow cytometry. It is suggested that most central neurocytomas follow a benign clinical course with low proliferative potential assessed by PCNA, AgNORs, and DNA flow cytometry; however, recurrence is possible within a relatively short time period.
作者分析了1982年1月至1993年12月期间在首尔国立大学医院诊断出的13例中枢神经细胞瘤，以明确这些肿瘤的增殖潜能和生物学行为。12例肿瘤局限于侧脑室和第三脑室，1例从丘脑后部延伸至侧脑室体部和三角区。所有13例均观察到典型的临床和影像学表现，并通过开颅手术进行组织学诊断。诊断采用光镜检查、神经元标志物免疫组化染色以及神经元分化的电镜检查结果。1例患者在次全切除加放射治疗后26个月因肿瘤进展伴复发死亡。另1例患者在肿瘤全切后18个月复发。其余11例患者在14至109个月（中位值50个月）的随访期内无肿瘤复发。为预测增殖潜能，对13例中的10例进行了增殖细胞核抗原（PCNA）免疫反应性检测、核仁组织区银胶体染色（AgNORs）以及DNA流式细胞术检测。所有病例中PCNA阳性细胞比例均小于1%，AgNORs评分范围为1.11至2.0（均值1.67）。DNA流式细胞术显示所有病例均为二倍体，计算出的增殖指数范围为5.1%至9.6%（均值7.8%）。作者对其进行增殖潜能研究的1例肿瘤复发病例以及另1例显示轻度核异型性的病例，在DNA流式细胞术中也显示PCNA阳性细胞百分比低、AgNORs评分低以及二倍体。提示大多数中枢神经细胞瘤临床病程呈良性，通过PCNA、AgNORs和DNA流式细胞术评估其增殖潜能较低；然而，在相对较短的时间内仍有可能复发。
