听神经瘤临床特征与肿瘤细胞增殖因子的相关性研究

Relevance between clinical behavior and bionomical findings of acoustic neuromas

目的探讨肿瘤增殖标记指数（labeling index，LI）Ki-67、增殖细胞核抗原（proliferating cell nuclear antigen，PCNA）、转移生长因子-β1（transforming growth factor-β1，TGF-β1）在听神经瘤组织标本中表达的意义及其与临床行为之间的相关性。方法回顾性分析听神经瘤手术患者53例的临床资料，对其石蜡切片病理标本进行Ki-67、PCNA和TGF-β1免疫组化学常规步骤染色。用SAS9．0统计软件包进行统计分析。结果53例中，Ki-67阳性率77．4％（41／53），PCNA阳性率84．9％（45／53）；Ki-67阳性与病程和临床生长率有关（t=2．14和2．70，P值均〈0．05）；PCNA阳性与临床生长率有关（t＇=-4．45，P〈0．05）；TGF-β1阳性表达83．0％（44／53），与Ki-67增殖标记指数呈正相关（r=0．36，P〈0．05）。53例中囊性变者比非囊变者肿瘤直径明显增大（Z=4．44，P〈0．05）；囊性变者与非囊变者，其肿瘤增殖标记指数Ki-67、PCNA、TGF-β1和病程之间无相关性。听神经瘤囊性变者比非囊变者临床生长率增大，但差异无统计学意义。结论Ki-67和PCNA与肿瘤的细胞增殖有关，增殖指数与临床生长率有关。双向调节因子TGF-β1参与了听神经瘤的生物学行为。囊性变听神经瘤，其增长与肿瘤的增殖活性关系不大，其增长是囊的容积增加，而非肿瘤细胞生长速度的加快。

Objective To evaluate the relationship between labeling index（LI） Ki-67, proliferating cell nuclear antigen （ PCNA ） and transforming growth factor-β1 （ TGF-β1 ） with the clinical behavior of acoustic neuroma. Methods Expression of Ki-67, PCNA and TGF-β1 was detected by immunohistochemistry in 53 specimens of acoustic neuromas. The relationship among tumor proliferation, histological representation, size of tumor, clinical proliferation index of tumor and tumor proliferation activity were analyzed. Results In all 53 cases, the positive rate of Ki-67 was 77.4% （41/53） but the positive rate of PCNA was 84.9% （45/53）. There was significant difference between the proliferate index, clinic growth rate and course of disease（t =2. 14, t =2. 70; P 〈0. 05）. The positive rate of TGF-β1 was 83. 0% （44/53）. The correlation of TGF-β1 with LI（ Ki-67 ） was significant difference （r = 0. 36 ,P 〈 0. 05 ）. Cystic degeneration often occurred in large-size tumor （Z = 4. 44 ,P 〈 0.05 ）. There was no significant relationship between the expression of LI（ Ki-67 ）, LI（PCNA） and TGF-β1 and the course of disease as well as between the cystic degeneration and the non-cystic degeneration. Although clinic growth rate of cystic degeneration was bigger than that of non-cystic degeneration, there was not statistically significant. Conclusions Ki-67 and PCNA are reflected proliferation activities of tumor cells in acoustic neuromas. Cell proliferation-labeling index LI（ PCNA）was related with clinical growth rates. TGF-β1 might participate in the biological behavior of acoustic neuroma. Cystic degeneration was one of special pattern of acoustic neuroma, however, tumor enlargement might due to the volume of the cystic but unrelate to fast proliferation of parenchyma cell.