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目的 探讨儿童髓母细胞瘤的预后因素。方法 采用组织病理学和免疫组化法对84例获随访的儿童髓母细胞瘤组织形态特征标志物表达以及P~(53)表达、VEGF、PCNA指数等进行比较研究。按术后生存期3年、5年、10年分别为A、B、C三组。结果 免疫组化标记显示66.7％病例可同时表达神经元标志物——突触素(Syn)和神经胶质标志物——胶质纤维酸性蛋白(GFAP)。A、B、C三组间P~(53)表达无显著性差异(P>0.05),而三组之间的VEGF和PCNA均有显著性差异(P<0.001)。结论 儿童髓母细胞瘤为原始种经外胚层肿瘤,P~(53)表达与其预后无关,但VEGF和PCNA可作为反映儿童髓母细胞瘤预后的生物学行为指标。
Objective To investigate the prognostic factors of childhood medulloblastoma. Methods The histopathological and immunohistochemical methods were used to investigate the histopathological markers, the expression of P53, VEGF and PCNA in 84 cases of childhood medulloblastoma. Survival after 3 years, 5 years, 10 years were A, B, C three groups. Results Immunohistochemical staining showed that 66.7% of the cases could simultaneously express neuronal markers Syn and glia marker glial fibrillary acidic protein (GFAP). There was no significant difference in the expression of P53 between A, B and C groups (P> 0.05), while there was a significant difference between the three groups in VEGF and PCNA (P <0.001). Conclusions Child medulloblastoma is a primitive ectodermal tumor. P53 expression has nothing to do with prognosis. However, VEGF and PCNA may be used as biological behavioral indexes to reflect the prognosis of children with medulloblastoma.