星形细胞瘤细胞谱系分型的研究

The lineage types in human astrocytomas

目的：探讨星形细胞瘤（ＡＳＡ）细胞谱系型别及其与生物学行为和病理学分级的关系。方法：免疫组化方法６０例人脑ＡＳＡ的Ａ２Ｂ５、ＧＦＡＰ及ＧＣ抗原表达和谱系分型。结果：４５例ＡＳＡ为１型谱系星形细胞瘤（Ｔ１ＬＡ）；１５例ＡＳＡ含较高密度的Ａ２Ｂ５＋细胞。为２型谱系星形细胞瘤（Ｔ２ＬＡ）。复发性肿瘤Ａ２Ｂ５标记指数显著高于非复发性病例，而ＧＦＡＰ标记指数呈现相反的结果。Ｔ２ＬＡ复发率显著高于Ｔ１ＬＡ（Ｐ＜０．０２）。１２例ＡＳＡ含有低密度的ＧＣ＋细胞。结论：Ｔ１ＬＡ比Ｔ２ＬＡ常见；以Ａ２Ｂ５和ＧＦＡＰ对ＡＳＡ进行谱系分型，有利于其诊断和复发性估计。ＧＣ标记利于识别星形－少枝混合性胶质细胞瘤。

Objective: To investigate the relationships between the cell lineages and different histopathologic grade. Methods: Using A2B5 monoclonal antibody, anti GFAP monoclonal antibody, and anti galactocerebroside (GC) polyclonal antibody with an immunohistochemistry (ABC method) to detect the expression of these antigens, 60 astrocytomas were examined. Results: 45 astrocytomas relatively lacked A2B5 antigen and shared the same lineage as type 1 astrocytes. 15 astrocytomas appeared to represent neoplasms with A2B5 positive lineage, thereby sharing the same lineage as type 2 astrocytes. The recurrence cases demonstrated significantly higher A2B5 label index and significantly lower GFAP label index than those of the nonrecurrence cases (P <0 02 and 0 01). And type 2 lineage tumors (T2LA) presented significantly higher recurrence rate than that of type 1 lineage tumors (T1LA) (P<0 02). 12 astrocytomas contained low densities of GC positive cells. Conclusions: T2LA is less common than T1LA. The lineage types using immunohistochemical analysis with A2B5 and GFAP may be useful in diagnosis and in predicting the recurrence ability of astrocytomas. GC label is useful in diagnosis of mixed oligo astrocytomas.