胶质瘤血管造影染色与肿瘤恶性程度及预后的关系  

Relationship between angiography of glioma and tumor malignancy as well as prognosis

作　　者：郭晓明[1] 李安民[1] 张志文[1] 傅相平[1] 赵明[1] 查韡光[1] 闫润民[1] 易林华[1] 刘爱军[1] 杨毅[2] 

机构地区：[1]中国人民解放军总医院第一附属医院神经外科,北京100037 [2]中国人民解放军总医院第一附属医院病理科,北京100037

出　　处：《中国微侵袭神经外科杂志》2006年第5期196-197,共2页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的研究胶质瘤病灶的血管造影表现与肿瘤新生微血管密度、恶性程度及预后的关系,为预测介入化疗的疗效及探索新治疗方法提供依据。方法对59例外科治疗后颅内残余瘤体最小径大于3cm的脑胶质瘤病人行DSA,对病灶染色情况进行分型,按Weidner法测定肿瘤微血管密度,并随访治疗恢复情况。结果非染色型胶质瘤病理构成以低级别胶质瘤为主,微血管密度为18.46±9.96,生存期43.1个月;羽状血管增生型以间变性星形细胞瘤为主,微血管密度为44.17±13.38,生存期24.7个月;斑片状浓染型以多形性胶质母细胞瘤为主,微血管密度为77.69±18.28,生存期14.9个月。统计分析结果显示:肿瘤灶染色类型与血管密度、病理类型均可反映胶质瘤的恶性程度,并与胶质瘤病人的生存期密切相关(P<0.05)。结论胶质瘤病灶染色能较好地反映肿瘤的微血管增生情况与恶性程度,可作为胶质瘤介入化疗中评估病情和疗效的客观指标。Objective To study the relationship between angiographic manifestations of glioma and tumor vessel density, tumor malignancy and prognosis to provide a basis for forecasting the therapeutic efficacy of intra-arterial chemotherapy and exploring new therapeutic methods. Methods DSA was performed in 59 patients with the residual tumors which was 〉3 cm in diameter and pathologically diagnosed as glioma. Pigmentation features of the lesions were classified, and the microvessel density of the tumors was measured by Weidner method. The patients were followed-up for therapeutic outcome, Results Unpigmented tumor was mainly low-grade glioma with microvessel density of 18.46±9.96 and mean survival of 43.1 months. Tumors with feather-like microvessel hyperplasia were composed of anaplastic astrocytomas with microvessel density of 44.17±13.38 and mean survival time of 24.7 months. Most patch-like pigmented tumors were glioblastoma multiforme with microvessel density of 77.69±18.28 and mean survival time of 14.9 months. The pigmentation of glioma and its pathological grade were closely related to its malignancy and the survival period （P〈0.05）. Conclusion Angiography may reveal microvessel hyperplasia and malignancy of glioma, thus providing an objective index to evaluate the state of illness and therapeutic efficacy of intra-arterial chemotherapy for glioma.

关 键 词：神经胶质瘤 脑血管造影术 微血管密度 预后 

分 类 号：R739.4[医药卫生—肿瘤]