脊索瘤中增殖细胞核抗原表达与细胞凋亡检测的临床意义

目的：探讨脊索瘤的组织特性及预后判断。方法：用免疫组化法检测16例原发脊索瘤（其中典型脊索瘤10例，软骨样脊索瘤6例）中增殖细胞核抗原（PCNA）的表达，TUNEL法检测其肿瘤细胞的凋亡，电镜观察其超微结构。结果：典型脊索瘤与软骨样脊索瘤PCNA的表达差异无显著性，但复发者PCNA的标记率明显较未复发者为高（P＜0．05）。软骨样脊索瘤肿瘤细胞的凋亡率较典型脊索瘤为高，但复发者肿瘤细胞的凋亡率与未复者相比较并无显著性差异。根治术无复发间期平均为26个月，次全切除术无复发间期平均为8个月（P＜0．05）。术后加用大剂量放疗，较未使用者的复发率为低，但无显著性差异。结论：索脊瘤复发与否与PCNA的标记率及手术方式有关，软骨样脊索瘤的预后较典型脊索瘤要好。

Expression of PCNA and detection of apoptosis and their significance in chordomas

Objective:To investigate the cytological features and the prognosis of chordoma.Method:An immunohistochemical staining was used to detect the expression of PCNA and TUNEL technique to show apoptotic cells in 10 cases of typical chordoma and 6 cases of chordroid variant of chordoma.Ultrastructural observation was performed in some cases.Result:The difference of PCNA labeled index (PCNA LI) was not significant between typical and chondroid variant of chordomas,but PCNA LI in recurring chordomas was significantly higher than that of non recurring chordomas.Apoptotic index of chondroid chordoma was significantly higher than that of typical chordoma.The mean disease free interval in patients performed radical surgery were 26 months, while that in patients performed subtotal resection were 8 months( P <0 05).Conclusion:The choice of surgical procedures and PCNA LI may be the prognostic factors of chordoma,and chondroid variant of chordoma may have a better prognosis than typical chordoma.