摘要
目的探讨胶质母细胞瘤的临床发病特点、病理学特点、影像学特点、诊断及鉴别诊断,进一步为临床治疗提供有效的参照。方法对2002年1月至2012年12月期间收治并获得组织病理学诊断的胶质母细胞瘤患者标本242例,应用HE染色、免疫组化等方法进行病理学特征观察,并结合CT和MR检查的影像特点进行综合分析。结果位于大脑229例,小脑9例,脑干2例,椎管2例;肿瘤所发生的部位直接影响到患者的主要症状表现:位于大脑半球主要表现为头痛、呕吐、脑膜刺激征、癫痫发作等;病变位于小脑主要表现为头晕、共济失调或行走不稳;椎管内肿瘤常表现为感觉运动障碍。免疫组化显示胶质纤维酸性蛋白(GFAP)和波形蛋白(vimentin)均呈强弱不等的阳性,Ki-67、CD34均高表达,其它标记物表达各不相同。CT和MR检查示界限不清的占位性病变常伴有出血、坏死和囊性变,增强扫描呈不规则环状强化。结论胶质母细胞瘤额叶、颞叶高发,肿瘤大小有逐年增加的趋势,恶性程度高,进展快,易复发。
Objective To analyze the clinical characteristics, pathological features, image fea- tures, diagnosis and differential diagnosis of glioblastoma and to provide effective references for clinical treatment. Methods During the period from January 2002 to December 2012, 242 ca- ses of glioblastoma were collected and analyzed with HE and immunohistochemical staining. The image features of CT and MR were also analyzed. Results The brain were 239 cases, the cer- ebellum were 9 cases, brainstem was 2 cases, spinal were 2 cases. The tumor site of occur- rence influenced the patients＇ main symptoms. The clinical symptoms of the cases were head- ache, vomiting, meningeal irritation, seizures in cerebral hemispheres and dizziness, ataxia or unsteady gait in the cerebellum. Spinal tumor usually presented sensorimotor disorder. Immu- nohistochemical study showed unequally positive staining for GFAP and vimentin. The Ki-67 and CD34 were highly expressed. The expression rates of other tumor markers were different. The CT and MR scanning showed occupying lesions with hemorrhage, necrosis and cystic de- generation. The irregular circularity enhancement was showed after enhancement scanning. Conclusion The incidence of frontal lobe and temporal lobe are high, and there is a rising trend of tumor size. The malignant degree of glioblastoma is very high, its progression is rapid, and it is easy to relapse.
出处
《哈尔滨医科大学学报》
CAS
北大核心
2013年第5期435-438,共4页
Journal of Harbin Medical University
基金
黑龙江省科技攻关项目(GC12C303-5)
