目的:通过检测髓母细胞瘤(Medulloblastoma)中凋亡抑制蛋白(survivin)的表达情况,探讨它的临床意义,为髓母细胞瘤的治疗寻求新的思路。方法:对50例髓母细胞瘤及10例正常脑组织石蜡切片行免疫组化检测,通过对survivin蛋白在髓母细胞瘤患者与正常脑组织中的表达差异,并运用相关统计分析方法分析它在不同性别、年龄段、肿瘤大小、病理类型、临床分期的表达差异及其与预后的相关性。结果:(1)髓母细胞瘤中survivin蛋白阳性表达率为72%,明显高于正常脑组织的阳性表达率0%,二者表达差异明显(P lt;0.01);亚组分析发现在survivin蛋白阳性组(n=36)和阴性组(n=14)病例中,性别分布、肿瘤部位、肿瘤大小、病理分型等因素在两者间无明显差别(P gt;0.05),而年龄及TM临床分期在两组间差异显著(P分别为0.044和0.027)。(2)survivin阳性患者预后与和阴性组相比差异显著(P=0.001)。结论:survivin可能参与了对髓母细胞瘤细胞凋亡的调控,并对髓母细胞瘤的发生发展可能起着重要作用。由于survivin蛋白表达与髓母细胞瘤患者年龄、临床分期及预后等也密切相关,可作为判断病情和评价预后的指标。
Citation:
WANG Duobin,JIANG Yongming,NU Mingxue,et al.. Survivin Expression in Medulloblastoma and its Clinical Significance. West China Medical Journal, 2009, 24(1): 1-4. doi:
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- 1. Bailey P,Cushing HW.Medulloblastoma cerebell:a common type of midcerebellar glioma of childhood[J].Arch Neurol Psychiatry,1925,14:192-223..
- 2. 王忠诚.神经外科学[M].第1版,湖北科学技术出版社,2002..
- 3. Walker RW,Rosenblum MK.Childhood medulloblastoma[M].Rev Neurol(Paris),1992:148-149..
- 4. Giangaspero F,Cenacchi G,Roncaroli F,et al.Medulloblastoma (lipidized medulloblastoma).A cerebellar neoplasm of adults with favorable prognosis[J].Am J Surg Pathol,1996,20(6):656-664..
- 5. 赵继宗.颅脑肿瘤外科学[M].第1版.北京:人民卫生出版社,2004..
- 6. Palmer SL,Goloubeva O,Reddick WE,et al.Patterns of intellectual development among survivors of pediatric medulloblastoma:A longitudinal analysis[J].J Clin Oncol,2001,19:23022308..
- 7. MacDonald TJ, Rood BR, Santi MR,et al.Advances in the diagnosis, molecular genetics, and treatment of pediatric embryonal CNS tumors[J]. Oncologist,2003,8(2):174186..
- 8. Michiels EM,Oussoren E,Van Groenigen M,et al.Genes differentially expressed in medulloblastoma and fetal brain[J].Physiol Genomics,1999,1:83-91..
- 9. Sasaki T,Lopes MB,Hankins GR,et al.Expression of survivin, an inhibitor of apoptosis protein, in tumors of the nervous system[J].Acta Neuropathol,2002,104(1):105-109 .
- 10. Caputy AJ,Mccullorgh DC,Manz HJ,et al.A review of the factors influencing the prognosis of medulloblastoma,the importance of cell differentiation[J].J Neurosurg,1987,66:80..
- 11. Packer RJ,Sutton LN,Rorke LB,et al.Prognostic of cellular differentiation in medulloblastoma of childhood[J].J Nurosurg,1984,61:296..
- 12. David KM, Casey AT, Hayward RD,et al.Medulloblastoma: is the 5year survival rate improving? A review of 80 cases from a single institution[J].J Neurosurg,1997,86(1):1321..
- 13. Giangasero F,Chieco P,Ceccarelli C,et al.“Desmoplastic”versus“classic” medulloblastoma,comparison of DAN content[J].Virchow Arch Pathol,1991,418:207-16..