Antidesmosomal monoclonal antibody in the diagnosis of intracranial tumours

Immunocytochemistry has been applied extensively to the diagnosis of intracranial tumours, but meningiomas still present a diagnostic problem. However, desmosomes have been shown by electron microscopy to be present in meningiomas, and this distinguishes them from gliomas. This paper describes a new monoclonal antibody, 11-5F, against desmosomal proteins 1 and 2 (desmoplakins) and assesses its usefulness in the diagnosis of meningiomas and other intracranial tumours. A total of 74 surgically removed intracranial tumours were examined by fluorescent antibody staining with 11-5F on frozen sections. In addition, a panel of antibodies against cytokeratin, vimentin, glial fibrillary acidic protein, and S100 protein was used. 11-5F stained 30/30 meningiomas and 14/14 metastatic carcinomas but 0/30 gliomas, thus distinguishing meningiomas and metastatic carcinomas from gliomas. The distinction between meningiomas and metastatic carcinomas on the basis of intermediate filaments staining was more difficult because neither the anticytokeratin nor the antivimentin antibody was specific for either tumour type. This study emphasizes the value of antidesmosomal antibodies as an important adjunct to the diagnosis of intracranial tumours.     

Intracranial ependymomas: Prognostic aspects

According to the grading of brain tumors as proposed by the WHO in 1976, out of 128 ependymomas 83 tumors could be classified as grade II and 38 as grade III Only seven subependymomas were benign and could be assigned to grade I.In contrast to most series known from the literature, 73 ependymomas were located above the tentorium and only 55 in the posterior cranial fossa. The grade of malignancy rised with an increased distance from the ventricular level.Macroscopically complete exstirpations were usually possible in hemispheric ependymomas, whereas tumors arising from the floor of the fourth ventricle often allowed only a partial removal. The operative mortality in the infratentorial group was more than twice as that in the supratentorial group.Postoperative survival was predominantly dependent on the histologic grade of malignancy. The five year survival rate without recurrence was 57.4% in grade II ependymomas as compared to 24.1% in grade III ependymomas. It could be improved by postoperative radiation therapy in both groups of malignancy. The almost identical longterm results indicate that even in less malignant ependymomas new tumor growth will occur later on.     

恶性脑胶质瘤术后替莫唑胺同步放化疗的疗效观察

目的探讨恶性脑胶质瘤术后替莫唑胺同步放化疗的疗效。方法选取2009-02—2010-08于我院就诊并住院的脑胶质瘤术后患者98例,分为单纯放疗组和同步放化疗组各49例,单纯放疗组接受单纯放疗(DT 60Gy),同步放化疗组在此基础上加服替莫唑胺75mg/(m2·d)同步化学治疗,放疗后口服替莫唑胺150~200mg/(m2·d),连续服用5d,每个疗程28d,服用6个疗程。2组治疗过程中均给予甘露醇和地塞米松等药物以降低颅内压。比较2组1、3、5a生存率。结果单纯放疗组1、3、5a生存率分别为61.22%、24.49%、14.29%,同步放化疗组分别为79.59%、51.02%、32.65%,同步放疗组疗效优于单纯放疗组(P0.05)。结论替莫唑胺同步放化疗在恶性脑胶质瘤术后的疗效优于术后单纯放疗。     

Low-grade thermal injury

It is very popular to use hot-water bottles or some electric heaters to keep one warm when sleeping or sitting in cold days in China.l Unfortunately, people might be burned as a result of prolonged contact with the heaters because of senseless due to falling asleep, drunk or some diseases just like diabetes. This special case we reported here may help us to improve the diagnosis and treatment of low-grade thermal injury.     

冠心病并发糖尿病患者血清肿瘤坏死因子水平的意义

目的探讨冠心病合并糖尿病患者肿瘤坏死因子-α(Tumor Necrosis Factorα,TNF-α)与病变之间的关系。方法检测年龄和性别无差异的正常组(n=26)、冠心病组(A组,n=34)、冠心病并糖尿病组(B组,n=30)3组HDL、空腹血糖、空腹胰岛素、甘油三酯(TG)、C反应蛋白(CRP)、TNF-α,白细胞介素-6(IL-6)含量。结果TNF-α在3组中的含量分别为(5.00±1.38)、(11.21±4.73)、(13.83±4.18)ng/L。3组比较有统计学差异(P=0.000)。3组以TNF-α为因变量,其它项目为自变量进行多元线性逐步回归分析,最后进入回归方程的变量为CRP、IL-6、HDL。结论TNF-α在糖尿病并冠心病的发病中起重要作用。     

Instructive cross-talk between neural progenitor cells and gliomas

Gliomas are the most common primary brain tumors and offer a poor prognosis in patients because of their infiltrative and treatment-resistant nature. The median survival time after diagnosis is approximately 11-12 months. There is a strong need for novel treatment modalities in targeting gliomas, and recent advances use neural progenitor cells as delivery systems for different therapeutic strategies. In this study, we show that rat embryonic neural progenitor cell (NPC) lines, transplanted at a distant site from a 3-day-preestablished glioma in the striatum, were able to migrate toward and colocalize with tumor isles without general spread into the brain parenchyma. Upon encounter with tumor, neural progenitor cells changed phenotype and became vimentin positive. These results demonstrate that transplanted neural progenitor cells respond to queues from a tumor and home to and exert an antitumor effect on the preestablished glioma, significantly decreasing the tumor volume with approximately 67% compared with control tumors after 1-2 weeks. Moreover, these early effects could be translated into increased survival times of animals treated with neural progenitor cell grafts 3 days after intrastriatal tumor inoculation. In contrast, there was no activation or migration of endogenous subventricular zone (SVZ) neuroblasts in response to an intrastriatal syngeneic tumor. In conclusion, NPC possess the ability to influence tumor growth as well as respond to queues from the tumor or tumor microenvironment, demonstrating a cross-talk between the cells.     

Interstitial stereotactic radiosurgery of pilocytic astrocytomas in paediatric patients

Summary Objective. To evaluate the clinical presentation, tumour response, clinical improvement and complications in 12 children and young people with a pilocytic astrocytoma, WHO I grade 1, who were treated with interstitial radiosurgery using Iodine-125 seed implants. Patients and Methods. Retrospective analysis of 12 patients aged under 18 years (mean 8.4 years, ranging from 8 months to 17 years of age) with a pilocytic astrocytoma treated between 1993 and 2006. Iodine-125 seeds were used as temporary implants with low-dose rate (≤10 cGy/h) and a calculated reference dose of 60 and 100 Gy to the outer ring of the tumour. Results. There was no perioperative mortality. Two patients worsened transiently, but thereafter each patient improved clinically. Eleven out of 12 tumours shrank after the treatment. The mean volume of the tumours before implantation was 17.9 cm³. and was reduced to 60% of this volume at 6 months, to 26.5% at 12 months, to 8% at 24 months, and was less than 1% at 30–36 months One patient underwent a reimplantation to treat a recurrence 3 years after the initial treatment. Ten patients were alive 2 years after the first intervention. In the longest surving patient, there was no evidence of progression after 13.4 years of follow up.     

MRI apparent diffusion coefficient reflects histopathologic subtype, axonal disruption, and tumor fraction in diffuse-type grade II gliomas

The apparent diffusion coefficient (ADC) determined from MR diffusion tensor imaging (DTI) has shown promise for distinguishing World Health Organization grade II astrocytoma (AS) from the more prognostically favorable grade II oligodendroglioma (OD). Since mixed oligoastrocytomas (OAs) with codeletions in chromosomes 1p and 19q confer prognoses similar to those of OD, we questioned whether a previously determined ADC-based criterion for distinguishing OD and AS would hold on an independent set of gliomas that included OA with codeleted or intact 1p/19q chromosomes. We also questioned whether the ADC is associated with the tumor microstructure. ADC colormaps generated from presurgical DTI scans were used to guide the collection of biopsies from each tumor. The median normalized ADC distinguished OD from AS with 91% sensitivity and 92% specificity. 1p/19q codeleted OAs were always classified as ODs, while 1p/19q intact OAs were always classified as ASs. There were positive associations between the ADC and both the SMI-31 score of axonal disruption and the fraction of tumor cells in the biopsies. The ADC of OD and 1p/19q codeleted OA was more associated with tumor fraction, while the ADC of AS and 1p/19q intact OA was more associated with SMI-31 score. We conclude that our previously determined threshold median ADC can distinguish grade II OD and AS on a new patient cohort and that the distinctions extend to OA with codeleted and intact 1p/19q chromosomes. Further, the ADC in grade II gliomas is associated with the fraction of tumor cells and degree of axonal disruption in tumor subregions.