35例原始神经外胚层肿瘤的病理及预后因素分析  

Pathology of primary neuroectodermal tumor and its prognostic factors:A report of 35 cases

作　　者：陈利娟[1] 贾永旭[1] 范菲菲[1] 李醒亚[1] 

机构地区：[1]郑州大学第一附属医院肿瘤科,郑州450052

出　　处：《第三军医大学学报》2010年第13期1391-1394,共4页Journal of Third Military Medical University

基　　金：国家自然科学基金(30672423)~~

摘　　要：目的探讨人原始神经外胚层肿瘤(primitive neuroectodermal tumors,PNET)的病理学特点及诊断标准,并分析影响患者预后的因素。方法收集2003年3月至2009年5月我科及河南省肿瘤医院收治的PNET患者35例,常规HE染色,免疫组织化学(EnVision法)检测CD99、FLI-1、Syn、NSE、S-100、NF、Vim在本组患者肿瘤组织中表达,并应用COX回归分析方法对其中临床资料完整的33例患者进行生存分析。结果 CD99阳性率为88.57%,FLI-1阳性率为51.43%,FLI-1与CD99联合灵敏度达100%;Vim、Syn、NSE和S-100阳性率分别为91.42%、48.57%、45.71%和22.86%;NF均为阴性。在其他因素不变的情况下,年龄因素对生存的影响无差异(P>0.05),而肿瘤的位置(原发肿瘤位于盆腔或中线位、非中线位)以及治疗方式(单纯局部治疗、局部治疗联合全身化疗)对生存的影响有差异(P<0.05)。结论 PNET的常规病理及免疫组化可提供诊断依据,免疫组化FLI-1和CD99结合能提高诊断的敏感性,肿瘤的原发位置及治疗方式是影响PNET患者预后的主要因素。Objective To study the pathology of primary neuroectodermal tumor （PNET）,and its diagnostic standards and prognostic factors.Methods Expression of CD99,FLI-1,Syn,NSE,S-100,NF,and Vim was detected in PNET tissues stained with HE and immmunohistochemistry （En Vision method）.Survival rate of 33 PNET patients with complete clinical information was analyzed with COX regression analysis method.Results The positive expression rate of CD99,FLI-1,Vim,Syn,NSE and s-100 was 88.57%,51.43%,91.42%,48.57%,45.71%,and 22.86%,respectively.The sensitivity of combined CD99 and FLI-1 was 100%.However,NF was not expressed in all PNET tissues.When other factors were unchanged,no difference was found in the effect of age on the survival rate of patients.However,a significant difference was observed in the effect of PNET site and its treatment modalities on the survival rate of patients （P0.05）.Conclusion Routine pathologic and immunohistochemical examination can provide diagnostic evidence of PNET.Detection of CD99 and FLI-1 expression with immunohistochemistry can increase the diagnostic sensitivity of PNET.The main factor affecting the prognosis of PNET is its primary site and treatment modality rather than the age of patients.

关 键 词：原始神经外胚层肿瘤 免疫组化 生存分析 

分 类 号：R446.8[医药卫生—诊断学] R730.264[医药卫生—临床医学]