Gilles F H, Sobel E L, Leviton A, Tavaré C J
Neuropathology, Department of Pathology and Laboratory Medicine, Childrens Hospital Los Angeles and University of Southern California School of Medicine, 90027, USA.
J Neurooncol. 1998 Aug;39(1):51-63. doi: 10.1023/a:1005984531474.
Five quantitative histologic factors, differing linear combinations of 26 reliably recognized histologic features, account for much of the histologic variance in 1068 children with infratentorial neuroglial tumors in the Childhood Brain Tumor Consortium (CBTC) database. In this study, we used the scores on the Spongy, Proliferative, Ring, Fibrillary, and Nuclear factors in cluster analyses and identified 11 clusters of children's tumors. Each had statistically significant differences in histology and relative histologic homogeneity. Three clusters had ependymoma-like histologic features; 4 had astrocytoma-like features; and 4 had primitive neuroectodermal-like (PNET or medulloblastoma) features. Each cluster had a unique high/low mean factor score pattern. Multiple operative and other clinical features characterized the three groups of clusters. We used Kaplan-Meier survival models to test for differences in survival among clusters and proportional hazards survival models to adjust for associated covariates. Among the 'ependymoma' clusters the 5 year survival probability ranged from 0.25 to 0.54. Among the 4 'astrocytoma' clusters, 5 year survival probability ranged from 0.59 to 0.94. The 5 year survival probability for the 'medulloblastoma' clusters ranged from 0.20 to 0.44. Within the three groups, clusters had differing covariates associated with survival. The tumor clusters identified in this study ensure relatively homogeneous histologic subsets. The five factor scores of a child's tumor provide the basis for finding the cluster nearest to that tumor. We propose that this tumor clustering strategy be employed for selection of children and for analyses of therapeutic clinical trials.
五个定量组织学因素，即26个可可靠识别的组织学特征的不同线性组合，解释了儿童脑肿瘤协会（CBTC）数据库中1068例幕下神经胶质瘤患儿的大部分组织学差异。在本研究中，我们在聚类分析中使用了海绵状、增殖性、环状、纤维状和核因素的评分，并识别出11个儿童肿瘤聚类。每个聚类在组织学和相对组织学同质性方面都有统计学上的显著差异。三个聚类具有室管膜瘤样组织学特征；4个具有星形细胞瘤样特征；4个具有原始神经外胚层样（PNET或髓母细胞瘤）特征。每个聚类都有独特的高/低平均因素评分模式。多种手术和其他临床特征可区分这三组聚类。我们使用Kaplan-Meier生存模型来检验聚类之间的生存差异，并使用比例风险生存模型来调整相关协变量。在“室管膜瘤”聚类中，5年生存概率范围为0.25至0.54。在4个“星形细胞瘤”聚类中，5年生存概率范围为0.59至0.94。“髓母细胞瘤”聚类的5年生存概率范围为0.20至0.44。在这三组中，聚类具有与生存相关的不同协变量。本研究中识别出的肿瘤聚类确保了相对同质的组织学子集。儿童肿瘤的五个因素评分提供了找到最接近该肿瘤的聚类的基础。我们建议将这种肿瘤聚类策略用于儿童的选择和治疗性临床试验的分析。
