摘要
研究背景:少突星形细胞瘤是最常见的混合性胶质瘤,由两种不同的肿瘤细胞组成,组织形态上分别与弥漫性星形细胞瘤和少突胶质瘤中的肿瘤细胞相似。由于这一形态学的异质性,在进行临床病理诊断时,很容易将该肿瘤描述为弥漫性星形细胞瘤或是单纯的少突胶质瘤。近些年来,正确诊断少突胶质瘤及少突星形细胞瘤对临床工作的影响越来越受到人们的重视。因为相对于星形细胞瘤来说,大多数少突胶质瘤患者对放、化疗敏感,生存期也较长。少突胶质瘤中,1号染色体短臂及19号染色体长臂的杂合性缺失(LOH 1p/19q)是其特征性的分子改变,与放、化疗的敏感性及较好的预后直接相关。而弥漫性星形细胞瘤很少有LOH 1p/19q,但具有特征性的17号染色体短臂的杂合性缺失(LOH 17p)或是TP53基因突变。目前,就有关少突星形细胞瘤的起源问题存在两种不同的观点,一种认为少突星形细胞瘤为单克隆起源,与单纯的少突胶质瘤同源,而另一种则认为少突星形细胞瘤存在两种遗传学亚型,一种与星形细胞瘤同源,另一种与少突胶质瘤同源。
目的:探讨少突星形细胞瘤中,组织形态炯异的两种肿瘤细胞成分(星形细胞部分与少突胶质部分)是否具有不同的分子遗传学改变。
方法:选择11例临床确诊的WHOⅡ级少突星形细胞瘤患者,其中二
Background: Oligoastrocytomas are glial tumors composed of a mixture of two distinct neoplastic cell types, morphologically corresponding to oligodendrogliomas and astrocytomas. These two different cell types coexist either separately in different areas of the tumor, or intermingled within the same areas of the tumor. Due to this heterogeneous morphology of oligoastrocytoma, the histopathological diagnosis is subjective and can easily be interpreted to be diffuse astrocytomas or pure oligodendrogliomas. The clinical impact of correct diagnosis of oligodendrogliomas as well as oligoastrocytomas has become clear during recent years. In contrast to astrocytomas, most patients with oligodendrogliomas are responsive to chemotherapy and have a longer overall survival. Somatic deletions on the short arm of chromosome 1 and the long arm of chromosome 19 (LOH 1p and LOH 19q) were shown to be directly associated with the chemosensitivity of the tumor, and are at present used as a molecular guide in the
引文
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