摘要
目的检测髓母细胞瘤CyclinD1和P16的表达,分析它们与临床病理特点之间的关系,探讨其对髓母细胞瘤预后的影响。方法通过免疫组化方法并用图像分析系统检测CyclinD1和P16在髓母细胞瘤和正常小脑组织中表达的积分光密度(IOD),分析它们与临床病理特点及预后的关系。结果(1)正常小脑组织CyclinD1表达较低,髓母细胞瘤表达增高;P16在正常小脑组织中呈现高表达,而髓母细胞瘤出现降低;(2)髓母细胞瘤CyclinD1和P16表达情况与患者年龄、肿瘤部位、病理类型、是否伴坏死、分化程度及分化方向有关(P<0.01或P<0.05);(3)经单因素分析和多因素分析显示肿瘤分化程度、CyclinD1和P16表达与患者生存期存在密切关系(P=0.0000)。结论(1)髓母细胞瘤中CyclinD1和P16表达改变,反映了肿瘤细胞增殖活性和细胞周期活性发生了改变,并且不同临床病理特点的髓母细胞瘤,增殖活性和细胞周期活性改变的程度并不一致。(2)髓母细胞瘤临床病理特点的不同更深层次的原因之一是肿瘤细胞CyclinD1和P16发生了不同变化从而导致肿瘤细胞形成各自不同的细胞周期改变。(3)CyclinD1和P16表达改变,为髓母细胞瘤的预后判断和临床治疗提供了新的思路。
Objective To search more stable prognostic factors by examining the expression of CyclinD1 and P16 in medulloblastoma, analysing its comelation with clinicopathological characteristics,and evaluating these factors that affect the prognosis of cerebellar medulloblastoma. Methods Sixty-two cases of medulloblastoma of the posterior fossa and ten cases of normal cerebellar tissues were studied via a combination of immuno- histochemical staining in formalin fixed paraffin-embedded sections, quantitative image analysis was performed with computer assisted pathological image analysis system.Using statistical analysis methods to analyse the correlation between the expression of CyclinD1 and P16 and clinicopathological characteristics, to study the factors that influence survival time. Results (1)The significantly statistic differences exist between the quantitive expression of CyclinD1 and P16 in medulloblastoma and normal cerebellar tissues. (2)The CyclinD1 and P16 expression is correlated with age, tumor location ,pathology type, necrosis, differentiation level and differentiation direction. (3)With simple analysis and Multivariate analysis, three factors showed significant dangers to survival: no differentiation, higer CyclinD1 expression and lower P16 expression. Conclusions (1)The alteration of CyclinD1 and P16 expression reflected the change of tumor cell proliferation activity and cell cycle activity. (2)Although the verified prognostic factors such as tumor location, histological type, necrosis, differentiation level were correlated with survival time, its influced survival time resulted from differentiation level and expression of CyclinD1 and P16 ultimatly.The one deeper reason of different clinicopathological characteristics of medulloblastoma is the different change of CyclinD1 and P16 expression that induces the different alteration of cell cycle. (3)The alteration of CyclinD1 and P16 expression not only are more reliable prognostic factors for medulloblastoma, but also can imply a new pathway for clinical treatment .
出处
《中华神经外科杂志》
CSCD
北大核心
2004年第5期377-380,共4页
Chinese Journal of Neurosurgery
