Clinicopathological Study of Diffuse Type Brainstem Gliomas : Analysis of 40 Autopsy Cases
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概要
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Diffuse type brainstem glioma is one of the most malignant types of brain tumors and the prognosis is extremely poor. The proliferative potential of these tumors is presumed to be very high, but there is little information about the cell kinetics of brainstem glioma because surgical resection is rarely performed. The histological grade, tumor spread, growth potential, and prognosis were evaluated in 40 autopsy cases of diffuse type brainstem glioma. To quantify the growth potentials of individual tumors, the proliferating cell indices of Ki-67 (MIB-1) and proliferating cell nuclear antigen (PCNA) monoclonal antibodies were measured. Mean MIB-1 and PCNA proliferating cell indices were 20.4% (24 cases) and 37.0% (28 cases), respectively, in 34 glioblastomas. The median survival time was 40 weeks in 22 treated patients. The mean PCNA proliferating cell index was 10.8% in four of five anaplastic astrocytomas and the median survival time in four treated patients was 91 weeks. The MIB-1 and PCNA proliferating cell indices of one astrocytoma were 2.9% and 20.3%, respectively, and the survival time was 56 weeks. The overall median survival time was 32 weeks. There was a significant difference in PCNA proliferating cell indices between glioblastomas and anaplastic astrocytomas (p < 0.05) and there was a significant difference in survival time between glioblastomas (40 weeks) and anaplastic astrocytomas plus astrocytoma (74 weeks) among the treated patients (p < 0.05). Supratentorial extension was more frequent in glioblastomas than in anaplastic astrocytomas (p < 0.05). Our results suggest that the majority of diffuse type brainstem gliomas are glioblastoma and the proliferative potential is probably as high as that of adult supratentorial glioblastoma. Supratentorial extension and dissemination are relatively frequent in the advanced stage. Anaplastic astrocytoma or astrocytoma is rarer and less infiltrative and proliferative, and carries a slightly better prognosis than glioblastoma.
- 日本脳神経外科学会の論文
- 2003-08-15
著者
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Onda Kiyoshi
Departments Of Neurosurgery Brain Research Institute Niigata University
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Tanaka Ryuichi
Departments Of Neurosurgery Brain Research Institute Niigata University
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Tanaka R
Department Of Neurosurgery Brain Research Institute Niigata University
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Tanaka Ryuichi
Department Of Neurosurgery Brain Research Institute Niigata University
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Takahashi Hitoshi
Department Of Emergency And Critical Care Kinki University School Of Medicine
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Onda Kiyoshi
Department Of Neurosurgery Brain Research Institute Niigata University
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Yoshimura Junichi
Departments Of Neurosurgery Brain Research Institute Niigata University:(present Address)department
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Yoshimura Junichi
Department Of Anesthesiology And Critical Care Medicine Faculty Of Medicine Kyushu University
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Takahashi H
Departments Of Pathology Brain Research Institute Niigata University
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Takahashi Hitoshi
Department Of Anatomy Hirosaki University School Of Medicine
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Takahashi Hitoshi
Department Of Agricultural Chemistry Faclty Of Horticulture Chiba University
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Tanaka Ryuichi
Department Of Liberal Arts Faculty Of Science And Technology Tokyo University Of Science
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