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背景:越来越多恶性脑胶质瘤存在的基因缺陷被发现,恶性脑胶质瘤的基因治疗逐渐成为热点,胶质瘤的治疗可以靶向于脑胶质瘤的基因缺陷。目的:研究中国人脑星形胶质细胞瘤中表皮生长因子受体(epidermalgrowthfactorreceptor,EGFR)的表达,并探讨其临床意义。设计:以金标准为依据的诊断性试验的病例观察性研究。地点、对象和干预:人脑星形胶质细胞瘤新鲜手术标本37例,其中男22例,女15例,年龄11～69岁,平均37岁,均来自于1998/2000长征医院手术病例。样本包含术中所切除肿瘤组织及配对瘤周组织,按照Kernohan病理分级,分为低级别组(Ⅰ～Ⅱ级,12例)和高级别组(Ⅲ～Ⅳ级,25例)。人脑胶质瘤细胞株U87MG,U251MG,大鼠脑胶质瘤细胞株C6。应用免疫组化方法(Evision-HRP法)检测人脑星形胶质瘤标本(含配对瘤周组织)和体外培养的多株人和大鼠胶质瘤细胞系的EGFR表达。主要观察指标:EGFR在人星形细胞瘤、脑胶质瘤细胞株中的表达;EGFR表达与肿瘤病理分极的相关性。结果:人脑星形胶质瘤组织EGFR阳性率为70%(26/37),明显高于瘤周组织(32%,12/37),差异有显著性意义(χ2=10.602,P<0.01)。Ⅲ～Ⅳ级肿瘤EGFR阳性率为84%(21/25),Ⅰ～Ⅱ级为42%(5/12),高级别组肿瘤EGFR表达水平显著低于低级别组,差异有显著性意义。(χ2=6.955,P<0.01
BACKGROUND: More and more genetic defects in malignant gliomas have been found. The gene therapy of malignant gliomas has become a hot spot. The treatment of glioma can target the genetic defects of glioma. Objective: To study the expression of epidermal growth factor receptor (EGFR) in Chinese human brain astrocytoma and to explore its clinical significance. Design: Case-observational study of diagnostic tests based on the gold standard. Location, Subjects and Interventions: A total of 37 fresh astrocytoma specimens were obtained from 22 surgical patients including 15 males and 15 females aged from 11 to 69 years (average 37 years old), all from the 1998/2000 Long March Hospital surgical cases. The specimens were divided into two groups: low grade group (Ⅰ ~ Ⅱ grade, 12 cases) and high grade group (Ⅲ ~ Ⅳ grade, 25 cases) according to Kernohan’s pathological grade. Human glioma cell line U87MG, U251MG, rat glioma cell line C6. Immunohistochemistry (Evision-HRP) was used to detect EGFR expression in human brain and rat glioma cell lines in human brain astrocytoma specimens (including matched peritumoral tissues) and in vitro. MAIN OUTCOME MEASURES: Expression of EGFR in human astrocytoma and glioma cell lines; Correlation between EGFR expression and tumor pathology. Results: The positive rate of EGFR in human brain astroglioma was 70% (26/37), which was significantly higher than that in peritumoral tissues (32%, 12/37) (χ2 = 10.602, P <0.01) ). The positive rates of EGFR in grade Ⅲ ~ Ⅳ tumors were 84% (21/25) and 42% (Ⅰ - Ⅱ) in grade Ⅰ ~ Ⅱ tumors. The expression of EGFR in grade Ⅲ ~ Ⅳ tumors was significantly lower than that in lower grade. The difference was significant. (χ2 = 6.955, P <0.01