Sharma M C, Rathore A, Karak A K, Sarkar C
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Pathology. 1998 Nov;30(4):355-9. doi: 10.1080/00313029800169626.
To gain a better insight into the biological behavior of central neurocytomas, various proliferative indices were studied in these tumors and correlated with the histological features as well as the clinical outcome. Twenty cases of neurocytoma were selected over a 16 year period (1980-1995), which accounted for 0.28% of all intracranial tumors reported at this centre. Treatment consisted of surgical resection (total 14, subtotal six) followed by radiotherapy. Except for five patients who died of surgical complications, the remaining 15 were all alive and well during the follow-up period, varying from six months to 72 months (average 32 months). Thirteen tumors showed benign histological characteristics (Group I) while seven showed mitoses + necrosis (Group II). The proliferative index was assessed in formalin-fixed paraffin-embedded tissue of 17 cases using the silver nucleolar organiser region (AgNOR) technique and immunohistochemical staining for proliferating cell nuclear antigen (PCNA-PC10 antibody) and Ki-67 antigen (MIB-1 monoclonal antibody). The AgNOR counts ranged from 1.2 to 2.6 (mean 1.9 +/- 0.4), PCNA labeling index (LI) from 0.1 to 5.5 (mean 2.5 +/- 1.8) and MIB-1 LI from 0.1 to 3 (mean 0.8 +/- 0.02). There was no significant difference in any of these parameter values between histological Groups I and II, except that MIB-1 LI tended to be higher in Group II tumors. Further, there was no significant correlation between these proliferative indices and the mitotic rate of the tumors as well as the survival of the patients. A longer follow-up will be required to determine the relationship between proliferative markers and outcome as well as to bring out any heterogeneity in their biological behavior. Since these are relatively rare tumors, multicentric pooling of data will be required to reach a definitive consensus regarding their biological aggressiveness and consequentially, the use of radiotherapy in their treatment. The present report is a contribution in this direction.
为了更深入地了解中枢神经细胞瘤的生物学行为，对这些肿瘤的各种增殖指数进行了研究，并将其与组织学特征以及临床结果相关联。在16年期间（1980 - 1995年）选取了20例神经细胞瘤病例，占该中心报告的所有颅内肿瘤的0.28%。治疗方法包括手术切除（全切14例，次全切6例），随后进行放疗。除5例死于手术并发症外，其余15例在随访期间均存活良好，随访时间从6个月至72个月不等（平均32个月）。13个肿瘤表现出良性组织学特征（I组），而7个肿瘤表现出有丝分裂 + 坏死（II组）。使用银染核仁组成区（AgNOR）技术以及针对增殖细胞核抗原（PCNA - PC10抗体）和Ki - 67抗原（MIB - 1单克隆抗体）的免疫组织化学染色，对17例福尔马林固定石蜡包埋组织的增殖指数进行了评估。AgNOR计数范围为1.2至2.6（平均1.9 +/- 0.4），PCNA标记指数（LI）为0.1至5.5（平均2.5 +/- 1.8），MIB - 1 LI为0.1至3（平均0.8 +/- 0.02）。在组织学I组和II组之间，这些参数值均无显著差异，只是II组肿瘤中的MIB - 1 LI往往更高。此外，这些增殖指数与肿瘤的有丝分裂率以及患者的生存率之间没有显著相关性。需要更长时间的随访来确定增殖标志物与结果之间的关系，并揭示其生物学行为中的任何异质性。由于这些是相对罕见的肿瘤，需要多中心汇总数据，以就其生物学侵袭性以及相应地在其治疗中使用放疗达成明确共识。本报告是朝着这个方向做出的贡献。
