Kiss R, Dewitte O, Decaestecker C, Camby I, Gordower L, Delbecque K, Pasteels J L, Brotchi J, Salmon I
Laboratoire d'Histologic, Faculté de Médecine, Cliniques Universitaires de Bruxelles, Belgium.
Am J Clin Pathol. 1997 Mar;107(3):321-31. doi: 10.1093/ajcp/107.3.321.
Tumor growth represents the ratio between cell gain (number of mitoses per unit of time, i.e., proliferative activity) and cell loss (number of cell deaths during the same unit of time). While in adults, proliferative activity parallels the level of malignancy in astrocytic tumors and therefore represents a useful diagnostic marker, cell loss has never been concomitantly assessed in tumors of this type. We hypothesize that cell density assessable on histologic slides represents the ratio between cell gain and cell loss. This hypothesis concerns only the diffuse type of astrocytic tumors. Proliferative activity (assessed by MIB1 antigen immunostain) and cell density were thus quantitatively assessed by means of a cell image processor in a series of 54 supratentorial astrocytic tumors of adult patients, which included 15 astrocytomas (ASTs), 18 anaplastic astrocytomas (ANAs), and 21 glioblastomas (GBMs). The results show that proliferative activity and cell density were highly correlated (P = .003) and that both correlated with histopathologic grade. The patients with a high-grade astrocytic tumor (i.e., ANA or GBM) that exhibited a low level of proliferative activity but high cell density survived for significantly shorter periods than did patients with a tumor that exhibited low proliferative activity and low cell density (P = .002). The patients with a high-grade astrocytic tumor that exhibited high proliferative activity and high cell density survived for significantly less time than did the patients with a tumor that exhibited high proliferative activity but low cell density (P < .05). A marked difference in survival periods was observed between the patients with a high-grade astrocytic tumor that exhibited a low level of proliferative activity and low cell density and the patients with a tumor that exhibited a high level of proliferative activity and high cell density (P < .001). The concomitant determination of proliferative activity and cell density seems likely to enable determination of the few adult patients who have high-grade astrocytic tumors and who will survive for a considerable period (several years).
肿瘤生长体现了细胞增殖（单位时间内的有丝分裂数量，即增殖活性）与细胞丢失（同一单位时间内的细胞死亡数量）之间的比率。在成年人中，增殖活性与星形细胞瘤的恶性程度平行，因此是一项有用的诊断标志物，但此类肿瘤中的细胞丢失情况从未得到过同步评估。我们推测，组织学切片上可评估的细胞密度代表了细胞增殖与细胞丢失之间的比率。这一推测仅适用于弥漫型星形细胞瘤。因此，我们借助细胞图像处理器，对一系列54例成年患者幕上星形细胞瘤进行了增殖活性（通过MIB1抗原免疫染色评估）和细胞密度的定量评估，这些肿瘤包括15例星形细胞瘤（AST）、18例间变性星形细胞瘤（ANA）和21例胶质母细胞瘤（GBM）。结果显示，增殖活性与细胞密度高度相关（P = 0.003），且二者均与组织病理学分级相关。高级别星形细胞瘤（即ANA或GBM）患者中，增殖活性低但细胞密度高的患者生存期明显短于增殖活性低且细胞密度低的肿瘤患者（P = 0.002）。高级别星形细胞瘤患者中，增殖活性高且细胞密度高的患者生存期明显短于增殖活性高但细胞密度低的肿瘤患者（P < 0.05）。增殖活性低且细胞密度低的高级别星形细胞瘤患者与增殖活性高且细胞密度高的肿瘤患者生存期存在显著差异（P < 0.001）。同步测定增殖活性和细胞密度似乎有助于确定少数患有高级别星形细胞瘤且生存期较长（数年）的成年患者。
