Objective: To study the relationship between deletion of P16 gene and occurrence and progression of astrocytomas Methods: The techniques of polymerase chain reaction (PCR) and immunohistochemistry were used to dete...Objective: To study the relationship between deletion of P16 gene and occurrence and progression of astrocytomas Methods: The techniques of polymerase chain reaction (PCR) and immunohistochemistry were used to detect the deletion of exon2 of P16 gene and expression of P16 gene in 52 cases of Brain astrocytoma Results: The deletion rate of exon2 of P16 gene in the tumors analyzed was 34 6% Most of them with deletion of exon2 of p16 gene were high grade astrocytomas (grade III 42%, grade IV 50%) 61 5% of the tumors were absent from expression of p16 and the deletion rate of p16 protein increased with the grade of astrocytoma (X 2=10 83, P <0 005) Conclusion: Deletion of p16 gene and protein may correlate with the malignant progression of astrocytoma展开更多
Objectives: The aim of the study is to assess volumetric Corticospinal Tract infiltration by Astro-cytoma using Diffusion Tensor Tractography. Material and Methods: Preoperative, anatomic (T1- and T2-weighted) and dif...Objectives: The aim of the study is to assess volumetric Corticospinal Tract infiltration by Astro-cytoma using Diffusion Tensor Tractography. Material and Methods: Preoperative, anatomic (T1- and T2-weighted) and diffusion tensor MRI were performed in 9 patients with supratentorial gliomas (WHO grade II and III). The tumors were manually segmented from the T1- and T2-weighted MRI, and their volume calculated. A three-dimensional tractography was performed in each case. A second segmentation and volume measurement was performed on the tumor regions intersecting adjacent white matter fiber tracts. Results: We identified that white matter tracts were infiltrated by 6 Astrocytoma tumors. The median tumor volume (±standard deviation) in our patient population was 33 ± 26.82 ml. The median tumor volume (±standard deviation) infiltrating white matter fiber tracts was 4.15 ± 9.23 ml. The median fraction of tumor volume infiltrating white matter fiber tracts was 26.3% ± 10.1%. Conclusions: Diffusion tensor MR Tractography is a reliable preoperative assessment tool since it detects extensive white matter infiltration by Astrocytoma irrespective of brain tumors volume. Recommendations: Prospective large population studies are required to clarify how infiltration relates to tumor location.展开更多
Nonresectable Low-Grade Astrocytomas (LGA) can compromise function and threaten life. For the majority of patients, the most appropriate strategy is initial chemotherapy followed by Radiation Therapy (RT). Since curat...Nonresectable Low-Grade Astrocytomas (LGA) can compromise function and threaten life. For the majority of patients, the most appropriate strategy is initial chemotherapy followed by Radiation Therapy (RT). Since curative treatment is not available for most of these patients, it is reasonable to conduct clinical studies to evaluate new agents. This Phase II study evaluates efficacy and safety of Antineoplastons A10 and AS2-1 (ANP) in LGA. Sixteen children diagnosed with LGA were treated. They included 12 males and 4 females, ages 1.6 - 17.4 years (median 10.6). Efficacy was evaluated in 16 patients. The majority of patients were previously treated, but 1 patient had stereotactic biopsy only. Out of the remaining 15 patients, 6 patients received chemotherapy, and 7 patients had surgery, and 2 patients received RT and chemotherapy after surgery. The patients received treatment with ANP administered daily every 4 hours (median dose of A10 was 7.71 g/kg/d and AS2-1 was 0.26 g/kg/d) until objective response or stable disease was documented and for 8 months thereafter. The duration of ANP IV ranged from 1.4 to 286 weeks with a median of 83 weeks. A complete response was documented in 25.0%, partial response in 12.5%, and stable disease in 37.5%. Overall survival was 67.7% at 5 years, and 54.2% at 10 and 15 years. Progression-free survival was 48.1%, 34.4% and 34.4% at 5, 10, and 15 years respectively. The treatment was associated with grade 3 or grade 4 Adverse Drug Experiences (ADE) in 6 patients. There were two hypernatremias of grade 4 (12%). Grade 3 ADE included urinary frequency (6%), fatigue (6%) and hypernatremia (6%). There were no chronic toxicities, and there was a high quality of survival. ANP shows efficacy with a very good toxicity profile in this cohort of children with low-grade astrocytoma.展开更多
目的应用磁敏感加权成像(susceptibility weighted imaging,SWI)对脑肿瘤瘤体实质的血管及微出血状态进行量化分析,探讨其对星形细胞瘤分级及其与单发脑转移瘤鉴别诊断的价值。材料与方法对42例经手术及病理证实的脑肿瘤患者行常规MRI...目的应用磁敏感加权成像(susceptibility weighted imaging,SWI)对脑肿瘤瘤体实质的血管及微出血状态进行量化分析,探讨其对星形细胞瘤分级及其与单发脑转移瘤鉴别诊断的价值。材料与方法对42例经手术及病理证实的脑肿瘤患者行常规MRI序列及SWI检查,包括星形细胞瘤Ⅰ级3例、Ⅱ级8例、Ⅲ级9例、Ⅳ级8例及转移瘤14例。SWI原始数据经处理得到滤过后相位图(CPI)、SWI最小密度投影图(SWIM i n I P)。将S W IM i n I P上肿瘤实质内线状或点状低信号结构定义为肿瘤内磁敏感信号(ITSS),计数肿瘤内所有层面ITSS数。星形细胞瘤不同级别之间、星形细胞瘤与转移瘤之间的ITSS差异用Wilcoxon检验进行分析。对于肿瘤之间有统计学差异的参数,采用ROC曲线分析其诊断敏感度、特异度。应用Spearman相关性分析星形细胞瘤级别与ITSS关系。结果Ⅰ级星形细胞瘤瘤内实质的ITSS数目均值为(3.00±2.65),Ⅱ级为(4.12±0.64),Ⅲ级为(18.11±2.15),Ⅳ级为(18.75±2.48)。Ⅱ级与Ⅲ级星形细胞瘤之间ITSS数目有显著差异(H=7.835,P<0.01);Ⅲ级与Ⅳ级之间ITSS无显著差异(H=0.021,P=0.885)。低级别(Ⅰ级与Ⅱ级)星形细胞瘤的ITSS明显小于高级别星形细胞瘤(Ⅲ级与Ⅳ级;H=13.156,P<0.01)。星形细胞瘤级别与ITSS呈正相关(r=0.746,P=0.000)。以7.5为鉴别高、低级别星形细胞瘤的ITSS阈值,敏感度为88.2%,特异度为81.8%,ROC曲线下面积(AUC)为0.912;以6.0为阈值鉴别Ⅱ级与Ⅲ级星形细胞瘤,敏感度为100%,特异度为87.5%,AUC为0.903。高级别星形细胞瘤瘤内实质的ITSS均值(18.41±1.58)明显高于转移瘤(6.14±1.56,P=0.001);以6.5为鉴别阈值,敏感度为94.1%,特异度为71.4%,AUC为0.861。结论肿瘤实质ITSS数量反映了肿瘤的微血管异质性,有助于星形细胞瘤的分级及其与转移瘤的鉴别诊断。展开更多
文摘Objective: To study the relationship between deletion of P16 gene and occurrence and progression of astrocytomas Methods: The techniques of polymerase chain reaction (PCR) and immunohistochemistry were used to detect the deletion of exon2 of P16 gene and expression of P16 gene in 52 cases of Brain astrocytoma Results: The deletion rate of exon2 of P16 gene in the tumors analyzed was 34 6% Most of them with deletion of exon2 of p16 gene were high grade astrocytomas (grade III 42%, grade IV 50%) 61 5% of the tumors were absent from expression of p16 and the deletion rate of p16 protein increased with the grade of astrocytoma (X 2=10 83, P <0 005) Conclusion: Deletion of p16 gene and protein may correlate with the malignant progression of astrocytoma
文摘Objectives: The aim of the study is to assess volumetric Corticospinal Tract infiltration by Astro-cytoma using Diffusion Tensor Tractography. Material and Methods: Preoperative, anatomic (T1- and T2-weighted) and diffusion tensor MRI were performed in 9 patients with supratentorial gliomas (WHO grade II and III). The tumors were manually segmented from the T1- and T2-weighted MRI, and their volume calculated. A three-dimensional tractography was performed in each case. A second segmentation and volume measurement was performed on the tumor regions intersecting adjacent white matter fiber tracts. Results: We identified that white matter tracts were infiltrated by 6 Astrocytoma tumors. The median tumor volume (±standard deviation) in our patient population was 33 ± 26.82 ml. The median tumor volume (±standard deviation) infiltrating white matter fiber tracts was 4.15 ± 9.23 ml. The median fraction of tumor volume infiltrating white matter fiber tracts was 26.3% ± 10.1%. Conclusions: Diffusion tensor MR Tractography is a reliable preoperative assessment tool since it detects extensive white matter infiltration by Astrocytoma irrespective of brain tumors volume. Recommendations: Prospective large population studies are required to clarify how infiltration relates to tumor location.
文摘Nonresectable Low-Grade Astrocytomas (LGA) can compromise function and threaten life. For the majority of patients, the most appropriate strategy is initial chemotherapy followed by Radiation Therapy (RT). Since curative treatment is not available for most of these patients, it is reasonable to conduct clinical studies to evaluate new agents. This Phase II study evaluates efficacy and safety of Antineoplastons A10 and AS2-1 (ANP) in LGA. Sixteen children diagnosed with LGA were treated. They included 12 males and 4 females, ages 1.6 - 17.4 years (median 10.6). Efficacy was evaluated in 16 patients. The majority of patients were previously treated, but 1 patient had stereotactic biopsy only. Out of the remaining 15 patients, 6 patients received chemotherapy, and 7 patients had surgery, and 2 patients received RT and chemotherapy after surgery. The patients received treatment with ANP administered daily every 4 hours (median dose of A10 was 7.71 g/kg/d and AS2-1 was 0.26 g/kg/d) until objective response or stable disease was documented and for 8 months thereafter. The duration of ANP IV ranged from 1.4 to 286 weeks with a median of 83 weeks. A complete response was documented in 25.0%, partial response in 12.5%, and stable disease in 37.5%. Overall survival was 67.7% at 5 years, and 54.2% at 10 and 15 years. Progression-free survival was 48.1%, 34.4% and 34.4% at 5, 10, and 15 years respectively. The treatment was associated with grade 3 or grade 4 Adverse Drug Experiences (ADE) in 6 patients. There were two hypernatremias of grade 4 (12%). Grade 3 ADE included urinary frequency (6%), fatigue (6%) and hypernatremia (6%). There were no chronic toxicities, and there was a high quality of survival. ANP shows efficacy with a very good toxicity profile in this cohort of children with low-grade astrocytoma.
文摘目的应用磁敏感加权成像(susceptibility weighted imaging,SWI)对脑肿瘤瘤体实质的血管及微出血状态进行量化分析,探讨其对星形细胞瘤分级及其与单发脑转移瘤鉴别诊断的价值。材料与方法对42例经手术及病理证实的脑肿瘤患者行常规MRI序列及SWI检查,包括星形细胞瘤Ⅰ级3例、Ⅱ级8例、Ⅲ级9例、Ⅳ级8例及转移瘤14例。SWI原始数据经处理得到滤过后相位图(CPI)、SWI最小密度投影图(SWIM i n I P)。将S W IM i n I P上肿瘤实质内线状或点状低信号结构定义为肿瘤内磁敏感信号(ITSS),计数肿瘤内所有层面ITSS数。星形细胞瘤不同级别之间、星形细胞瘤与转移瘤之间的ITSS差异用Wilcoxon检验进行分析。对于肿瘤之间有统计学差异的参数,采用ROC曲线分析其诊断敏感度、特异度。应用Spearman相关性分析星形细胞瘤级别与ITSS关系。结果Ⅰ级星形细胞瘤瘤内实质的ITSS数目均值为(3.00±2.65),Ⅱ级为(4.12±0.64),Ⅲ级为(18.11±2.15),Ⅳ级为(18.75±2.48)。Ⅱ级与Ⅲ级星形细胞瘤之间ITSS数目有显著差异(H=7.835,P<0.01);Ⅲ级与Ⅳ级之间ITSS无显著差异(H=0.021,P=0.885)。低级别(Ⅰ级与Ⅱ级)星形细胞瘤的ITSS明显小于高级别星形细胞瘤(Ⅲ级与Ⅳ级;H=13.156,P<0.01)。星形细胞瘤级别与ITSS呈正相关(r=0.746,P=0.000)。以7.5为鉴别高、低级别星形细胞瘤的ITSS阈值,敏感度为88.2%,特异度为81.8%,ROC曲线下面积(AUC)为0.912;以6.0为阈值鉴别Ⅱ级与Ⅲ级星形细胞瘤,敏感度为100%,特异度为87.5%,AUC为0.903。高级别星形细胞瘤瘤内实质的ITSS均值(18.41±1.58)明显高于转移瘤(6.14±1.56,P=0.001);以6.5为鉴别阈值,敏感度为94.1%,特异度为71.4%,AUC为0.861。结论肿瘤实质ITSS数量反映了肿瘤的微血管异质性,有助于星形细胞瘤的分级及其与转移瘤的鉴别诊断。
