Ⅱ级星形胶质细胞瘤复发恶性变的相关分子特点观察  

Molecular characteristics of recurrence and malignant transformation of grade Ⅱ astrocytoma

作　　者：孙晓玲[1] 张晓娟[1] 张清泉[1] 邱雷[1] 王林娜[1] 侯素平[1] SUN Xiao-ling;ZHANG Xiao-juan;ZHANG Qing-quan;QIU Lei;WANG Lin-na;HOU Su-ping(Department of Pathology,Harrison International Peace Hospital,Hengshui 053000,Hebei,China)

机构地区：[1]哈励逊国际和平医院病理科

出　　处：《广东医学》2019年第22期3147-3151,共5页Guangdong Medical Journal

基　　金：河北省医学科学研究重点课题(编号:20160327)

摘　　要：目的探讨Ⅱ级星形胶质细胞瘤复发恶性变的相关分子特点。方法选取57例Ⅱ级星形胶质细胞瘤患者。根据临床进程不同将患者均分为3组(未复发组、复发进展组以及复发无进展组)。切取标本,检测3组p21、Ki-67、TP53蛋白质分子水平、染色强度评分,并进行基因测序。结果复发进展组的TP53蛋白质分子表达水平明显高于未复发组、复发无进展组,差异有统计学意义(P<0.05)。复发无进展组TP53蛋白质分子水平明显高于未复发组,差异有统计学意义(P<0.05)。复发进展组p21、Ki-67与未复发组、复发无进展组差异无统计学意义(P>0.05)。复发进展组、复发无进展组TP53染色强度评分明显高于未复发组,差异有统计学意义(P<0.05)。复发进展组TP53表达水平最高,其余p21、Ki-67各组间对比差异无统计学意义(P>0.05)。在5例组织中发现6个(共4类)突变,包括外显子5、7、8三个外显子(各1例病变),另外1例同时存在2个突变。所有突变者都是恶性进展组病例。结论Ⅱ级星形胶质细胞瘤复发恶性变的分子特点包括TP53基因突变、蛋白质分子过表达,其对提示此疾病复发与进展具有重要的预示作用,值得临床重点关注。Objective To investigate the molecular characteristics of recurrence and malignant transformation of gradeⅡastrocytoma.Methods 57 patients with gradeⅡastrocytoma from July 2017 to August 2018 were selected.Patients were divided into three groups according to different clinical stages(non-recurrence group,progression group and recurrence non-progression group).Specimens were collected and molecular level and staining intensity scores of p21,Ki-67 and TP53 among the three groups were detected.Gene sequencing was performed.Results The TP53 protein expression level in the recurrence progression group was significantly higher than that in the non-recurrence group and the recurrence progression group,and the difference was statistically significant(P<0.05).The level of TP53 protein in the recurrence non-progression group was significantly higher than that in the non-recurrence group,and the difference was statistically significant(P<0.05).There was no significant difference in p21 and Ki-67 between the recurrence progression group and the non-recurrence group and the recurrence progression group(P<0.05).The TP53 staining intensity score of the recurrence progression group and the recurrence non-progression group was significantly higher than that of the non-recurrence group,and the difference was statistically significant(P<0.05).The TP53 expression level was the highest in the recurrence progression group,and there was no significant difference between the other groups of p21 and Ki-67(P>0.05).6 mutations were found in 5 tissue samples,including exon 5,exon 7 and exon 8(1 lesion each),and the other sample had 2 mutations at the same time.All mutations were in the malignant progression group.Conclusion The molecular characteristics of recurrence and malignant transformation of gradeⅡastrocytoma include TP53 gene mutation and over-expression of protein molecules,which has an important predictive role on the recurrence and progression of the disease.

关 键 词：染色强度评分 TP53 Ⅱ级星形胶质细胞瘤 外显子 

分 类 号：R73[医药卫生—肿瘤] R74[医药卫生—临床医学]