胶质瘤的WHO新分类病理诊断:附1498例统计分析

Pathological Diagnosis with WHO New Classification of the Gliomas: Statistic Analysis of 1498 Cases

背景和目的:胶质瘤的临床、病理学改变,遗传学中基因丢失和生物学行为表现等,均反映于新的WHO分类之中,新分类赋予许多肿瘤类型以新的概念,本文旨在了解应用新的WHO分类诊断后各种神经上皮组织肿瘤的统计学意义。并对少突胶质肿瘤和星形细胞肿瘤的诊断标准作简要讨论。方法:对1999年7月～2002年月6月3年间华山医院收治的1498例胶质瘤.所有病例均经免疫组化(ABC法)用20余种抗体标记。应用WHO(2000)神经系统肿瘤新分类作病理诊断,并作统计分析。结果:在1498例神经上皮组织肿瘤中,按新分类属星形细胞肿瘤881例(58.93%)、少突胶质细胞肿瘤313例(20.94%)、室管膜肿瘤137例(9.16%)、神经上皮组织的胚胎性肿瘤73例(4.88%)、节细胞胶质瘤56例(3.56%)、脉络丛肿瘤11例(0.74%)、其他肿瘤(包括少突星形细胞瘤8例,来源未定的胶质瘤10例和松果体肿瘤4例)22例(1.46%)。结论:采用WHO新分类诊断,少突胶质细胞肿瘤比例较以往增加,而星形细胞瘤有减少。

BACKGROUND & OBJECTIVE: The clinical - pathological characteristics, the pattern of gene deletions and the biological behaviors of the gliomas were reflected in the new WHO classification of brain tumors. The new classifications included new concepts into many types of the tumors. This paper is to show the important statistical findings on pathological classification of the neuroepithelial tumors using the new WHO classification. The diagnosis criteria of the astrocytic and oligodendroglial tumors were also discussed. METHODS: 1498 cases of the gliomas treated in Huashan Hospital during 3 years period (between 1999.7～2002.6) were analyzed using immunocytochemistry (ABC method) with 20 antibodies. The diagnoses were based on the new WHO classification. The incidence was analyzed. RESULTS: Among the 1498 cases astrocytic tumors were 881 cases (58.93%), oligodendroglial tumors were 313 cases (20.94%), ependymal tumors were 137 cases (9.16%), embryonal tumors of the neuroepithelial tissue were 73 cases (4. 88%), neuronal and mixed neuronal - glial tumors were 56 cases (3.56%), choroid plexus tumors were 11 cases (0.74%), and other gliomas including mixed gliomas, neuroblastic tumors and pineal parenchymal tumors were 27 cases (1. 46% ). CONCLUSIONS: According to new WHO classification, the ratio of astrocytic tumors decreased but that of oligodendroglial tumors were increased as compared with previous report.