摘要
目的分析35例原发性胶质母细胞瘤临床病理特征、免疫表型、影像学特点、诊断及鉴别诊断。方法对2004年1月-2017年12月收治的胶质母细胞瘤患者第1次手术标本35例,应用HE染色、免疫组化等方法进行病理学特征观察,并结合CT和MR检查的影像特点进行综合分析。结果胶质母细胞瘤临床表现主要为头痛、头晕、呕吐,CT和MR检查示颅内界限不清的占位性病变,常伴有出血、坏死和囊性变。组织学显示瘤细胞弥漫分布,异型性明显,微血管增殖明显,常伴坏死,坏死灶周围瘤细胞常排列呈栅栏状。免疫组化显示GFAP和vimentin均呈阳性,Olig-2表达较高,Ki-67表达较高,其它抗体的表达不尽相同。结论胶质母细胞瘤来源于星形细胞,恶性程度高,进展快,易复发,病理全面取材可以更好评价预后,目前的治疗方法主要采用手术切除加放、化疗。
Objective To profile the clinicopathologic characteristics,immunophenotype,imaging features,diagnosis and differential diagnosis of primary glioblastoma by retrospective analysis of 35 cases.Methods Thirty-five glioblastoma specimens have been collected from 35 patients in our hospital during their first surgery from January 2000 to December 2017.The lesions were examined histopathologically using H&E and IHC staining,which were combined with the CT and MR imaging results for a comprehensive evaluation of primary glioblastoma.Results The main clinical manifestations of glioblastoma were headache,dizziness,vomiting.CT scans and MR examination indicated the ill-defined occupying lesions in the brain parenchyma usually accompanied with hemorrhage,necrosis and cystic degeneration.Histopathological examination showed the tumor cells are characterized by diffuse distribution,apparent atypia,prominent microvascular proliferation,frequent necrosis usually surrounded by palisaded tumor cells.IHC results demonstrated positive GFAP and vimentin staining,high Olig-2 and Ki-67 expression,while the expression of other markers varied.Conclusions Glioblastoma is derived from astrocytes,characterized by high grade malignancy,rapid progression and easy recurrence.Comprehensive histopathlogical examination is beneficial to prognosis prediction after the contemporary treatment with surgery combined with radiotherapy and chemotherapy.
作者
姜忠彩
周琦
王福娟
JIANG Zhongcai;ZHOU Qi;WANG Fujuan(Aviation General Hospital,Beijing,100012,China)
出处
《航空航天医学杂志》
2019年第12期1434-1437,共4页
Journal of Aerospace medicine
