CD34在难治性癫痫相关脑肿瘤中的表达及鉴别诊断意义

Expression and diagnostic significance of CD34 in brain tumors of patients with refractory epilepsy

目的探讨CD34在难治性癫痫相关脑肿瘤中的表达情况及其在鉴别诊断中的应用价值。方法应用免疫组织化学EnVision法检测CD34在54例难治性癫痫相关脑肿瘤中的表达情况，包括50例混合性神经元．胶质肿瘤和4例多形性黄色瘤型星形细胞瘤（PXA）。其中前者包括21例神经节细胞胶质瘤（GG），8例胚胎发育不良性神经上皮瘤（DNT）和21例组织学形态介于胶质神经元错构性病变和混合性神经元一胶质肿瘤之间具有过渡特征的病变。另外9例胶质瘤的表达情况作为对照，包括4例胶质母细胞瘤和5例混合性星形一少突胶质细胞瘤。结果CD34在21例GG中的20例、8例DNT中的1例、21例具有过渡特点的混合性神经元-胶质肿瘤／病变中的16例及4例PXA中的3例的肿瘤区域为阳性；在伴有肿瘤周边组织的病例中，18例GG中的9例、18例具有过渡特点的混合性神经元一胶质肿瘤／病变中的6例及3例PXA中的1例的肿瘤周边组织为阳性，定位于胞质、胞膜和细胞突起。CD34仅在1例胶质母细胞瘤病变区域少数细胞呈阳性。CD34在不同类型肿瘤病变和周边脑组织区域表达方式不尽相同。结论CD34在GG、PXA中阳性表达率高于DNT和对照组胶质瘤，对于诊断GG、PXA及与DNT、混合性星形一少突胶质细胞瘤、胶质母细胞瘤相鉴别具有一定的应用价值。

Objective To study the immunohistochemieal expression and diagnostic signifieanee of CD34 in brain tumors of patients with refractory epilepsy. Methods Immunohistoehemieal study for CD34 was performed on formalin-fixed paraffin-embedded tissue blocks of 54 cases of brain tumors occurring in patients with refractory epilepsy. The tumor types included ganglioglioma （GG, number = 21 ）, dysembryoplastie neuroepithelial tumor （ DNT, number = 8 ）, tumors/lesions which bad the transitional features that between glioneuronal hamartia and mixed neuronal-glial tumor （number = 21 ） and pleomorphic xanthoastroeytoma （ PXA, number = 4 ）. Cases of glioblastoma （ number = 4 ） and oligoastroeytoma （ number = 5 ） were used as controls. Results Twenty of the 21 cases of GG, 1 of the 8 eases of DNT, 16 of the 21 eases of tumors/lesions whieh had the transitional features and 3 of the 4 eases of PXA showed cytoplasmic and membranous positivity for CD34. The adjoining brain tissues in 9 of thel8 eases of GG, 6 of the 16 eases of tumors/lesions which had the transitional features and 1 of the 3 eases of PXA also expressed CD34. In contrast, only 1 ease of glioblastoma showed membranous positivity for CD34. Conclusions CD34 preferred to staining for GG and PXA. Which represent a valuable tool for distinguishing GG, PXA and DNT, oligoastroeytoma, glioblastoma.