Vaz R, Borges N, Sarmento A, Azevedo I
Institute of Pharmacology and Therapeutics, Medical Faculty, Porto, Portugal.
J Neurooncol. 1996 Feb;27(2):127-32. doi: 10.1007/BF00177475.
With the aim of studying the putative involvement of peritumoral microvessels in the formation of brain edema, small pieces of peritumoral brain tissue were removed from six patients with glioblastoma multiforme submitted to surgery. All patients had cerebral edema, as shown by preoperative C.T. and N.M.R. Control specimens were obtained from four patients undergoing ventriculo-peritoneal shunt. The tissue fragments were fixed in glutaraldehyde-osmium and embedded in Epon. In semi-thin sections observed under light microscopy peritumoral endothelial cells exhibited voluminous cytoplasm and nucleus. Under the electron microscope, capillary cells from glioblastoma patients differed from controls mainly by showing nuclei rich in euchromatin, cytoplasm rich in pinocytotic vesicles and with occasional fenestrations. All these morphological characteristics are compatible with a process of reversion of phenotype of capillaries around glioblastomas to that of periphery as well as an increase in permeability. Both events may be due to diffusion of a tumoral vascular permeability/endothelial growth factor. This peripheral vessel phenotype of peritumoral microvessels supports their participation in the formation of brain edema and may provide a new clue for therapeutic intervention: for example it fits quite well to the known increase in permeability by leukotrienes and decrease in permeability by corticosteroids in tumoral edema.
为了研究肿瘤周围微血管在脑水肿形成中可能的作用，从6例接受手术的多形性胶质母细胞瘤患者身上取下小块肿瘤周围脑组织。所有患者术前CT和核磁共振成像均显示有脑水肿。对照标本取自4例接受脑室-腹腔分流术的患者。组织碎片用戊二醛-锇固定并包埋在环氧树脂中。在光学显微镜下观察的半薄切片中，肿瘤周围的内皮细胞显示出大量的细胞质和细胞核。在电子显微镜下，胶质母细胞瘤患者的毛细血管细胞与对照相比有差异，主要表现为核内富含常染色质、细胞质内富含吞饮小泡且偶尔有窗孔。所有这些形态学特征都与胶质母细胞瘤周围毛细血管表型向周边表型的逆转过程以及通透性增加相一致。这两个事件可能是由于肿瘤血管通透性/内皮生长因子的扩散所致。肿瘤周围微血管的这种外周血管表型支持它们参与脑水肿的形成，并可能为治疗干预提供新的线索：例如，这与已知的白三烯使肿瘤水肿通透性增加、皮质类固醇使通透性降低的情况非常吻合。
