论文部分内容阅读
背景:脑胶质瘤病灶介质中富含新生血管,血管内皮生长因子表达不同可能与其病理表现和复发存在一定的相关性。目的:分析血管内皮生长因子在复发脑胶质瘤中表达的特征。设计:对照实验。单位:四川大学华西医院神经外科。对象:从华西医院1996-06/2001-06手术切除且病理证实为脑胶质瘤143例石蜡标本中,收集临床资料完整且相同的个体复发前、后脑胶质瘤标本44例(22对)。取首次手术及第1次复发手术标本。其中Ker-nohan评分Ⅰ级8例;Ⅱ级10例;Ⅲ级14例;Ⅳ级12例。分为初发和复发2组,每组22例。方法:采用免疫组织化学SP法,一抗羊抗人血管内皮生长因子IgG(单抗)、二抗兔抗羊IgG,工作度1:50,阴性对照为磷酸盐缓冲液置换一抗染色。检测44例复发前、后的脑胶质瘤病理组织中血管内皮生长因子蛋白表达水平,结合病理分级作对照分析。①胞浆内呈棕黄色颗粒为阳性信号。②在MPIAS-500型多媒体彩色病理图文分析系统上,对肿瘤细胞进行表达强度PU值(阳性单位)和细胞数测定。③PU值95%临界值,分别计数阳性细胞率。④常规苏木精-伊红染色Kernohan病理分级。主要观察指标:①脑胶质瘤复发前、后标本血管内皮生长因子表达强度PU值。②脑胶质瘤复发前、后组病理分级。结果:①脑胶质瘤血管内皮生长因子表达强度PU值:初发组为21.9273±6.607,复发组为33.0545±6.684。②病理分级:初发Ⅰ级8例,复发Ⅱ级2例、Ⅲ级5例、Ⅳ级1例;初发Ⅱ级6例,复发Ⅱ级2例、Ⅲ级1例、Ⅳ级3例;初发Ⅲ级6例,复发Ⅲ级2例、Ⅳ级4例;初发Ⅳ级2例,复发Ⅳ级2例。③脑胶质瘤复发前、后标本血管内皮生长因子蛋白表达PU值和肿瘤复发前、后病理分级各自对比检验差异均有显著性(P<0.05)。结论:血管内皮生长因子表达强度在脑胶质瘤复发较初发时增加明显,复发肿瘤恶化趋势与血管内皮生长因子的高表达在胶质瘤的复发中呈一致性。
BACKGROUND: Cerebral glioma is characterized by the presence of neovascular vessels in the media and the different expression of vascular endothelial growth factor may be related to its pathological appearance and recurrence. Objective: To analyze the expression of vascular endothelial growth factor in recurrent glioma. Design: Control experiment. Unit: Department of Neurosurgery, West China Hospital, Sichuan University. PARTICIPANTS: Totally 44 cases (22 pairs) of glioma specimens from complete and identical individuals before and after recurrence were collected from the paraffin-embedded specimens of 143 cases of glioma who were surgically removed and pathologically confirmed from West China Hospital from June 1996 to June 2001. . Take the first operation and the first recurrence of surgical specimens. Which Ker-nohan score Ⅰ grade 8 cases; Ⅱ grade 10 cases; Ⅲ grade 14 cases; Ⅳ grade 12 cases. Divided into initial and recurrent 2 groups, each group of 22 cases. Methods: Immunohistochemical SP method was used. Anti-goat anti-human vascular endothelial growth factor IgG (McAb) and secondary anti-goat anti-goat IgG were used. The working efficiency was 1:50. The negative control was phosphate buffered saline (PBS). 44 cases of recurrence before and after glioma pathological tissue vascular endothelial growth factor protein levels, combined with pathological grade control analysis. ① cytoplasm brown particles were positive signals. ② In the MPIAS-500 multimedia color pathological image analysis system, the expression of tumor cells PU value (positive units) and cell number determination. ③ PU value of 95% of the critical value, were counted positive cell rate. ④ conventional hematoxylin-eosin staining Kernohan pathological grade. MAIN OUTCOME MEASURES: ① PU value of vascular endothelial growth factor expression in glioma before and after recurrent. ② glioma recurrence before and after the group pathological grade. Results: ① The PU value of glioma vascular endothelial growth factor was 21.9273 ± 6.607 in primary group and 33.0545 ± 6.684 in recurrent group. ② Pathological grade: 8 cases were grade Ⅰ, 2 cases were grade Ⅱ, 5 cases were grade Ⅲ and 1 case was grade Ⅳ; 6 cases were grade Ⅱ, 2 cases were grade Ⅱ, 1 case was grade Ⅲ and 3 were grade Ⅳ; Grade Ⅲ in 6 cases, recurrence in grade Ⅲ in 2 cases, grade Ⅳ in 4 cases; grade Ⅳ in 2 cases, recurrent grade Ⅳ in 2 cases. (3) There was significant difference (P <0.05) between the PU value of vascular endothelial growth factor protein expression before and after recurrence of glioma and the pathological grading before and after tumor recurrence. Conclusion: The expression of vascular endothelial growth factor (VEGF) in glioma was significantly higher than that in primary glioma. The trend of recurrence was consistent with the high expression of vascular endothelial growth factor in glioma recurrence.