Prayson R A
Department of Anatomic Pathology, Cleveland Clinic Foundation, OH 44195, USA.
Mod Pathol. 1997 Apr;10(4):304-10.
Few studies have examined cell proliferation or p53 immunoreactivity in myxopapillary ependymomas. This study retrospectively examines tumor MIB-1 and p53 immunohistochemical features in 14 patients (eight women, six men; age range, 12-69 yr; median, 32 yr) with myxopapillary ependymoma. Their preoperative symptoms lasted from 2 months to 18 years (median, 12 mo) and most commonly involved lower back pain. The tumor was in the lumbar spinal cord region in 12 patients, the sacral cord in 1, and both the lower thoracic and upper lumbar cord in 1. In three patients, cerebrospinal fluid protein levels were markedly elevated, with negative cytologic results. Thirteen patients underwent a gross total resection. All of the tumors demonstrated histologic features diagnostic of myxopapillary ependymoma. Four cases had focal, prominent, nuclear pleomorphism. From 1 to 5 mitotic figures per 10 high power fields were identified in four tumors. There was no vascular proliferation or necrosis. Nine patients are alive at last known follow-up with no evidence of tumor (median, 36 mo); four are alive with residual tumor (median, 40 mo); and one died after 74 months (tumor status unknown). Eleven patients received adjuvant radiation and/or chemotherapy. Six experienced at least one tumor recurrence at intervals of 20 to 132 months. MIB-1 indices on the initial tumor resection ranged from 0 to 5.5 (median, 0.9) in 12 cases. In three patients with recurrent tumor, MIB-1 indices were higher in the initial tumor in two cases and lower in one. p53 Immunostaining of 13 tumors showed rare positive-staining tumor cell nuclei. The conclusions are that myxopapillary ependymomas grow slowly; that MIB-1 labeling indices are unreliable predictors of tumor recurrence; and that the lack of p53 immunostaining in most myxopapillary ependymomas in this series suggests that this gene might not play a significant role in the pathogenesis of these tumors.
很少有研究检测黏液乳头型室管膜瘤中的细胞增殖或p53免疫反应性。本研究回顾性分析了14例黏液乳头型室管膜瘤患者（8例女性，6例男性；年龄范围12 - 69岁，中位年龄32岁）的肿瘤MIB - 1和p53免疫组化特征。他们的术前症状持续2个月至18年（中位时间12个月），最常见的症状是下背部疼痛。12例患者的肿瘤位于腰髓区域，1例位于骶髓，1例位于下胸髓和上腰髓。3例患者脑脊液蛋白水平显著升高，细胞学检查结果为阴性。13例患者接受了肿瘤全切术。所有肿瘤均表现出黏液乳头型室管膜瘤的组织学特征。4例有局灶性、显著的核多形性。4个肿瘤中每10个高倍视野可识别1至5个有丝分裂象。无血管增殖或坏死。在最后一次已知随访时，9例患者存活且无肿瘤证据（中位时间36个月）；4例有残留肿瘤存活（中位时间40个月）；1例在74个月后死亡（肿瘤状态不明）。11例患者接受了辅助放疗和/或化疗。6例患者至少有一次肿瘤复发，复发间隔为20至132个月。12例患者初次肿瘤切除时的MIB - 1指数范围为0至5.5（中位值0.9）。3例复发肿瘤患者中，2例初次肿瘤的MIB - 1指数较高，1例较低。13个肿瘤的p53免疫染色显示罕见的阳性染色肿瘤细胞核。结论是黏液乳头型室管膜瘤生长缓慢；MIB - 1标记指数不是肿瘤复发的可靠预测指标；本系列大多数黏液乳头型室管膜瘤缺乏p53免疫染色表明该基因可能在这些肿瘤的发病机制中不起重要作用。
