星形细胞瘤核仁组成区嗜银蛋白图像分析及其在预后判断中的意义

Image analysis of AgNORs distribution and its prognostic significance incerebral glioma

采用图像分析技术对３６例有随访资料的星形细胞肿瘤瘤细胞和血管内皮细胞核仁组成区嗜银蛋白（ＡｇＮＯＲｓ）颗粒进行定性、定量研究发现，随肿瘤级别增高ＡｇＮＯＲｓ平均数目（ＭＧ）显著增多，颗粒总面积（ＡＴ）增大；颗粒平均面积（ＡＭ）变化不显著，但均小于正常组。４倍体（４Ｃ）以上的肿瘤ＭＧ高于４Ｃ以下者。肿瘤组内皮细胞ＭＧ显著高于非肿瘤组。各参数间也呈显著相关性，ＭＧ与ＤＮＡ含量、ＡＴ与核面积均呈正相关，ＡＭ与ＭＧ呈负相关。ＭＧ对患者病程有显著影响，ＭＧ＜２者一般为良性，ＭＧ＞２者一般为恶性。不同预后的患者ＭＧ均值间亦有显著差异。预后与ＡＭ也有关，ＡＭ越小，术后病程越短。结果表明，采用图像分析技术对ＡｇＮＯＲｓ测定能较客观地反映星形细胞瘤增殖活性和分化程度，并有助于判断预后。

The silver-binding nucleolar organizer regions(AgNORs)were studied quantitatively and qualtitatively with real color imagte analysis in the tumor cells and the vascular epithelium of 36 cases of astrocytic tumors of the brain and the cases were followed up. It was found that the average number of AgNOR granules(MG)and the total area of the granules (AT)were increased along with the increase of the grading of the tumor but the average area of granules (AM)was smaller in astrocytoma than in normal astrocytes though the difference was not significant. MG was larger in tumors showing tetraploids and over than in the tumors showing less than tetraploids. MG was larger in the epithelium of tumor tissue than in that of normal tissue. Positive correlation was found between the values of MG and DNA content and between those of AT and nuclear area and negative correlation between AM and MG. The value of MG affected the survival time of the patient. As a rule the tumor was benign when MG was smaller than 2 and malignant when it was larger than 2.The MG of patients with different prognosis was also different significantly. The prognosis was also related to AM, that is, the smaller the AM, the shorter the survival time.All these findings suggest that image analysis of AgNORs is able to reveal the proliferation and differentiation of astrocytes which is of significance in the prognosis of the patient.In addition, the mechanism of Ag-NOR increase was discussed.