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目的 :探讨脊索瘤的组织特性及预后判断。方法 :用免疫组化法检测 16例原发脊索瘤 (其中典型脊索瘤 10例 ,软骨样脊索瘤 6例 )中增殖细胞核抗原 (PCNA)的表达 ,TUNEL法检测其肿瘤细胞的凋亡 ,电镜观察其超微结构。结果 :典型脊索瘤与软骨样脊索瘤PCNA的表达差异无显著性 ,但复发者PCNA的标记率明显较未复发者为高 (P <0 0 5 )。软骨样脊索瘤肿瘤细胞的凋亡率较典型脊索瘤为高 ,但复发者肿瘤细胞的凋亡率与未复者相比较并无显著性差异。根治术无复发间期平均为 2 6个月 ,次全切除术无复发间期平均为 8个月 (P <0 0 5 )。术后加用大剂量放疗 ,较未使用者的复发率为低 ,但无显著性差异。结论 :脊索瘤复发与否与PCNA的标记率及手术方式有关 ,软骨样脊索瘤的预后较典型脊索瘤要好
Objective: To investigate the histopathological characteristics and prognosis of chordoma. Methods: The expression of proliferating cell nuclear antigen (PCNA) in 16 cases of primary chordoma (typical chordoma in 10 cases and chondroid chordoma in 6 cases) was detected by immunohistochemical method. Tumor cell apoptosis was detected by TUNEL method. Observe its ultrastructure. Results: There was no significant difference in PCNA expression between typical chordomas and chondroid-like chordomas. However, the recurrence rate of PCNA was significantly higher than those without recurrence (P < 0.05). The apoptotic rate of chondroid-like chordoma tumor cells is higher than that of typical chordomas, but there is no significant difference in the apoptotic rate between relapsed tumor cells and those who have not. The interval between radical resections without recurrence was 26 months, and the average time between subtotal resections without recurrence was 8 months (P < 0.05). The use of high-dose radiotherapy after surgery was lower than the non-user recurrence rate, but there was no significant difference. Conclusion : The recurrence of chordoma is related to the labeling rate and surgical approach of PCNA. The prognosis of chondroid chordoma is better than that of typical chordoma.