星形细胞肿瘤染色体10q杂合性缺失的临床病理学分析

Clinical and pathologic analysis of astrocytic tumors with loss of heterozygosity on chromosome 10q

目的探讨星形细胞肿瘤染色体10q杂合性缺失与其病理特征、发生发展及预后的关系。方法应用间期荧光原位杂交（FISH）技术检测85例星形细胞肿瘤组织（WHOⅡ级35例，WHOⅣ级50例）中染色体10q的杂合性缺失情况。结果（1）35例弥漫型星形细胞瘤（WHOⅡ级）中，22例（62．9％）无异常改变，6例（17．1％）染色体10q杂合性缺失，7例（20．0％）10号染色体多体。50例胶质母细胞（WHOⅣ级）中，5例（10．0％）无异常改变，34例（68．0％）染色体10q杂合性缺失，11例（22．0％）10号染色体多体。（2）染色体10q在低年龄组的缺失率为36．4％（12／33），高年龄组的缺失率为82．4％（28／34），二者差异有统计学意义（P〈0．05）；在弥漫型星形细胞瘤的缺失率为21．4％（6／28），胶质母细胞瘤的缺失率为87．2％（34／39），二者差异有统计学意义（P〈0．05）。单因素生存分析结果显示，年龄、肿瘤级别、染色体10q杂合性缺失与星形细胞肿瘤患者术后生存时间相关（P〈0．05）。结论星形细胞肿瘤染色体10q杂合性缺失与患者的年龄、肿瘤级别有关。10q杂合性缺失与星形细胞肿瘤的进展有关，对星形细胞肿瘤患者的预后评估具有一定的价值。

Objective To study the correlation between loss of heterozygosity （LOH） on chromosome 10q and pathologic features, pathogenesis, prognosis of astrocytic tumors. Methods LOH on 10q was studied by interphase fluorescence in-situ hibridization （FISH） in 85 cases of astrocytic tumor, including 35 cases of WHO grade Ⅱ tumors and 50 cases of WHO grade Ⅳ tumors. Results LOH on 10q was detected in 6 cases （17. 1%） of diffuse astrocytoma （WHO grade Ⅱ ） and 34 cases （68.0%） of glioblastoma （WHO grade Ⅳ ）. 10q polysomy was detected in 7 cases （20. 0% ） of diffuse astrocytoma and 11 cases （22. 0% ） of glioblastoma. The rates of LOH on 10q in young age group and elderly group were 36.4% （12/33） and 82.4% （28/34）, respectively. The difference was of statistical significance （P 〈0. 05）. The rates of LOH on 10q in the diffuse astrocytoma and glioblastoma were 21.4% （6/28） and 87. 2% （34/39）, respectively. The difference was also statistically significant （ P 〈 0. 05 ）. Univariate survival analysis showed that patient age, pathologic grade and 10q on LOH correlated with duration of survival （P 〈0. 05 ）. Conclusions There are correlation between 10q LOH, patient age and pathologic grade of astrocytic tumors. LOH on 10q is also related to the pathogenesis of astrocytic tumors and is helpful in predicting prognosis.