论文部分内容阅读
目的 分析幕上星形细胞瘤 (AstrocytomaAM)的倍体及影响预后的病理因素。方法 通过细胞图像光度术(ICM)对 68例不同预后的AM进行DNA倍体测定 ,并对 1 0项临床病理指标和1 0项计量指标进行Cox回归分析。结果 分级越高 ,其DNA含量 ,异倍体发生率越高。Ⅰ级无异倍体 ,Ⅱ、Ⅲ、Ⅳ级异倍体发生率分别为 52 .6 %、80 %、1 0 0 %。生存分析显示 ,年龄 <40岁、Ⅰ级、二倍体、无坏死和核分裂及瘤巨细胞、每高倍视野增生微血管数 <40个者的AM患者存活时间明显延长 (P <0 .0 0 5) ,而本组资料的肿瘤大小、有否钙化、是否为复发、有否化疗和放疗、S期比率等与预后无关。多因素Cox回归分析显示肿瘤DNA含量、倍体、核分裂数和年龄为影响预后的危险因素 ,4者与存活时间均呈负相关关系。结论 DNA倍体测定能提高对星形细胞瘤的预后判定作用。
Objective To analyze the ploidy of supratentorial astrocytoma (AstrocytomaAM) and the pathological factors that influence the prognosis. Methods DNA ploidy was performed on 68 patients with different prognoses by cell image photometry (ICM). Cox regression analysis was performed on 10 clinicopathological parameters and 10 measures. Results The higher the grade, the higher the DNA content and the heteroploid incidence. Grade I was not aneuploid and the incidence of grade II, III, and IV aneuploidy was 52.6%, 80%, and 100%, respectively. Survival analysis showed that the survival time of AM patients with age <40 years old, grade I, diploid, non-necrotic and mitotic and giant cell tumors, and the number of proliferating microvessels < 40 per high-power field was significantly prolonged (P < 0.05). ), but the size of the tumor in this group of patients, whether there is calcification, whether it is recurrence, whether there is chemotherapy and radiotherapy, S ratio, etc. have nothing to do with the prognosis. Multivariate Cox regression analysis showed that tumor DNA content, ploidy, number of mitoses, and age were risk factors for prognosis, and there was a negative correlation between the 4 and survival time. Conclusion DNA ploidy assay can improve the prognosis of astrocytoma.