胶质瘤血管生成拟态的临床意义

目的 探讨胶质瘤患者血管生成拟态(VM)存在的临床意义.方法 收集手术治疗的109例脑星形胶质细胞肿瘤患者的临床资料,应用HE染色、CD34和PAS双重染色,观察胶质瘤是否存在VM,并做相关参数的单因素分析、Kaplan-Meier生存比较.结果 在109例患者中13例(11.9%)肿瘤标本中发现VM,VM与患者性别、年龄、肿瘤部位等无相关性,但是与WHO组织学分级相关:WHO Ⅰ级VM阳性率为0(0/5).WHOⅡ级VM阳性率为5.5%(2/36),WHOⅢ级VM阳性率为7.3%(3/41),Ⅳ级VM阳性率为29.6%(8/27).组织学级别之间的阳性率差异有统计学意义(P=0.028).Kaplan-Meier生存分析提示有VM组和无VM组患者生存时间差异有统计学意义(P=0.031).结论 胶质瘤中存在VM,VM与胶质瘤的级别相关,VM阳性患者具有较差的预后.

Clinical significance of vasculogenic mimicry in human gliomas

Objective Vasculogenic mimicry (VM) is a newly recognized phenomena in many malignancies. However, we did not know its clinical significance in gliomas.This study was designed to investigate VM in gliomas and compare clinical data of patients. Methods One hundred and nine glioma specimens were collected for immunohistochemical staining of CD34 and PAS staining (dual staining) to verify the existence of VM.The clinical data of those glioma patients were collected and analyzed. Results The VMhad been considered for those stained positively for PAS, but negatively for endothelial marker-CD34.VM phenotypes were found in 13 specimens(11.9%). Most of the VM were found in higher grades gliomas:8 of 27 grade Ⅳ (29.6%), 3 of 41 grade Ⅲ(7.3%), and 2 of 36 grade Ⅱ(5.5%).While there was no VM found in grade Ⅰgliomas.The higher grade gliomas had higher incidence of VM expression than that of lower grade gliomas (P=0.028).There was no any association between the existence of VM and the sex,age and preoperative epilepsy of the patients.However,the patients whose tumors with VM expression survived shorter than those without VM (P=0.031).Conclusion VM exists in gliomas.Higher grades gliomas exhibit more VM than that of the lower grades gliomas. Glioma patients with VM may have poorer prognosis.