p14^ARF／p16β与Oct-4、Nestin、GFAP在不同组织结构类型的神经母细胞瘤中的表达及意义  

Expression and significance of p14^ARF/p16β, Oct-4, Nestin and GFAP in different histological types of neuroblastoma

作　　者：顾松[1] 徐敏[1] 洪莉[1] 张忠德[2] 殷敏智[2] 陈其民[1] 吴晔明[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心外科,200127 [2]上海交通大学医学院附属上海儿童医学中心病理科,200127

出　　处：《中华小儿外科杂志》2008年第9期534-537,共4页Chinese Journal of Pediatric Surgery

基　　金：国家自然科学基金（30600751）

摘　　要：目的探讨p14^ARF／p16β与Oct-4、Nestin、GFAP在不同组织结构类型的神经母细胞瘤（组织结构良好型，FH型；组织结构不良型．UFH型）中的表达及其意义。方法收集近6年来本院保存的儿童神经母细胞瘤石蜡标本33例．男17例．女16例；年龄范同1个月～15岁，平均年龄33．1个月；随访时间21～87个月，平均随访时间45．5个月，其中UFH神经母细胞瘤10例，平均肿瘤分期3期；FH神经母细胞瘤23例，平均肿瘤分期2．57期。利用组织芯片的高通量、低误差、经济省时等优点，将二组标本制作成组织芯片，再行免疫组织化学SP法检测p14^ARF／p16β与Oct-4、Nestin、GFAP在神经母细胞瘤中的表达。结果相对于FH神经母细胞瘤，UFH神经母细胞瘤中的p14^ARF／p16β表达明显下降，差异有统计学意义（P〈0．／15）；而Nestin和GFAP在二组肿瘤中表达均较低。Oct-4二组表达类似，二组之间差异无统计学意义（P〉0．05）。UFH组失随访1例．平均随访时间34．5个月，随访时存活率66．6％；FH组失随访2例，平均随访时间49．5个月，随访时存活率80．9％，二组之间差异有统计学意义（P〈0．05）。结论p14^ARF／p16β基因的失活在肿瘤的发生巾起着重要作用，UFH神经母细胞瘤中p14^ARF／p16β的低表达表明了肿瘤分化较差，肿瘤分期较高；而Nestin、Oct-4和GFAP表达类似，表明了不同组织结构类型的神经母细胞瘤（FH型和UFH型）均具有一些最原始的神经干细胞的生物学特征，具有进一步分化的潜力．并使得神经母细胞瘤进展迅速，旱现恶性的组织表型。FH型预后相对较好，可能与患儿不同的年龄、肿瘤分期、是否转移和复发均有关。Objective To investigate the expression of p14^ARF/p16β, Oct-4, Nestin and GFAP in different histological types of neuroblastoma and its clinical significance. Methods Over the past six years, 33 cases （7 male and 16 female） with neuroblastoma were treated in this institute. The age of these patients ranged from I month to 15 years with an average age of 33. 1 months. Twenty-three were favorable histology （FH） and the otber 10 with unfavorable histology （UFH）. The expressions of p14^ARF/p16β, Oct-4, Nestin, and GFAP in neuroblastoma were detected with SP immunohistochemistry stain. SAS statistical software was used for statistical analysis of the results using Wilcoxon rank sum test. All patients were followed up from 21 to 87 months with an average of 45.5 months. Results Compared to the FH neuroblastoma, p14^ARF/p16β expression in UFH neuroblastoma was significantly decreased, the difference was statistically significant （P〈0. 05）. However, Nestin and GFAP showed lower expression in both groups. Oct 4 expressed similarly in these two groups without statistically significant difference （P〉0.05） between them. In UFH group, the average follow-up period was 34. 5 months, with the survival rate of 66.6% ： In FH group, the average follow-up period was 49. 5 months, with the survival rate of 80. 9% ; there was a significant difference between these two groups （P〈0. 05）. Conclusions The inactivation of p14^ARF/p16β gene might play an important role in carcinogenesis of neuroblastoma.

关 键 词：神经母细胞瘤 免疫组织化学 肿瘤分期 患儿 

分 类 号：R739.4[医药卫生—肿瘤]