摘要
目的 :分析原发性中枢神经系统淋巴瘤 (PCNSL)的VEGF表达分布和测量其微血管密度 (MVD) ,旨在提高PCNSL早期诊断率和判断预后 ,同时为影像学提供理论依据。方法 :对 2 2例PCNSL临床 (包括影像学 )病理资料分析 ,同时行VEGF及CD34免疫组化标记 ,并测量MVD ,以 12例胶质瘤作为对照。结果 :2 2例PCNSL中单发者 17例 (占 77 2 7% ) ;多发者 4例 ,共有病灶 10处 ;1例为弥漫浸润型。肿瘤位于脑白质深部者 15例 (占 5 5 5 6 % )、脑表面及灰白质交界区者 8例、胼胝体者4例。CT示肿瘤为边界清楚的高密度结节或肿块。组织病理学示瘤细胞弥漫分布 ,瘤细胞大小较一致 ,胞质少 ,核大 ,可见瘤细胞围绕血管呈“袖套样”浸润。淋巴瘤MVD值 (2 1 8± 11 6 )与恶性胶质瘤组 (44 4± 16 8)的差异有非常显著性 (t =3 374 ,P <0 0 1)。VEGF表达无特异性 ,与对照组比较无统计学意义。结论 :病理学基础决定了影像学的特征。血管生成活性的不同 ,有助于PCNSL与恶性胶质瘤的鉴别 ,并对其预后的判断有一定帮助 ,VEGF可能是恶性肿瘤重要的促血管生成因子 ,但对于鉴别诊断无特异性。
Purpose The expression of vascular endothelial growth factor(VEGF), and pathological data of primary central nervous system lymphoma (PCNSL) were analyzed, in order to increase the early diagnostic accuracy and the underlying theory of imaging. Methods Twenty two cases of PCNSL proved by pathology were reviewed, including imaging and pathological data. Micro vessel density (MVD) and VEGF protein expression in 22 of PCNSL cases were examined. 12 cases of gliomas were used as control. Results Seventeen cases had single lesion (77 27%), 4 cases had multiple lesions and one case manifested diffuse intra cerebral infiltration. 15 lesions (55 56%) located in the deep white matter, 4 in callus corpus, and 8 in the surface. On CT scanning, iso or hyper dense to gray matter with homogeneous enhancement following IV contrast injection. Histopathologically, the tumor cells spread everywhere with the same size. The cells had little cytoplasm and large nucleus, and thick chromatin granules. The tumor cells infiltrated around the vessels. No haemorrhage, calcification and necrosis were seen in PCNSL. The MVD of PCNSL (21 8±11 6) was significantly lower than those of malignant astrocytoma ( t=3 374,P <0 01). Conclusions The characteristics of imaging have their pathological basis. The difference of angiogenesis activity is helpful for differential diagnosis of PCNSL from malignant astrocytoma. VEGF may be an important angiogenesis stimulator to malignant tumors but its diagnostic value is limited.
出处
《临床与实验病理学杂志》
CAS
CSCD
2002年第4期366-370,共5页
Chinese Journal of Clinical and Experimental Pathology
