Oligoastrocytomas: A clinicopathological study of 52 cases

被引:43
作者
Krouwer, HGJ
vanDuinen, SG
Kamphorst, W
vanderValk, P
Algra, A
机构
[1] UNIV UTRECHT HOSP,DEPT NEUROL,UTRECHT,NETHERLANDS
[2] UNIV LEIDEN HOSP,DEPT NEUROPATHOL,NL-2300 RC LEIDEN,NETHERLANDS
[3] FREE UNIV AMSTERDAM HOSP,DEPT NEUROPATHOL,AMSTERDAM,NETHERLANDS
关键词
oligoastrocytoma; astrocytoma; oligodendroglioma; St Anne Mayo grading system; proliferating cell nuclear antigen; survival;
D O I
10.1023/A:1005731305078
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Oligoastrocytomas form a poorly defined subgroup of glial tumors, and few clinical series have been reported. We performed a retrospective study to elucidate the histopathological features of these tumors and to relate the clinical signs and symptoms and proliferative potential to survival. Oligoastrocytomas were defined as glial tumors with at least 10% neoplastic astrocytes and 10% neoplastic oligodendrocytes; tumors were graded with the St. Anne-Mayo criteria for astrocytomas and oligodendrogliomas. Proliferative potential was estimated with antibodies against proliferating cell nuclear antigen (PCNA). Median survival of 52 patients (median age, 42 years) was 75 weeks (range 2-703 weeks). Actuarial 1-, 2-, 3-, and 5-year survival rates were 67%, 43%, 40%, and 29%, respectively. For 15 patients with grade 3 and 33 with grade 4 lesions (St. Anne-Mayo astrocytoma classification), median survival was 217 and 55 weeks, respectively. For 19 patients with grade 2 and 33 with grade 3 lesions (St. Anne-Mayo oligodendroglioma classification), median survival was 305 and 55 weeks, respectively. Interobserver agreement between three experienced neuropathologists on identification of astrocytes, oligodendrocytes, and unclassifiable cells was low, indicating considerable subjectivity in the histopathological diagnosis. Median PCNA labeling indices correlated with tumor grade, but individual values varied so widely within grades that they had no predictive value for survival. In a multivariate analysis, symptoms of increased intracranial pressure and microvascular proliferation were independently associated with poor prognosis. The biological behavior of subgroups appeared to be distinctly less aggressive than that of 'pure' astrocytomas of similar grade. Better histopathological definition of oligoastrocytomas and improved assessment of percentages of constituent cell types may allow more accurate prognosis.
引用
收藏
页码:223 / 238
页数:16
相关论文
共 71 条
  • [11] COX DR, 1972, J R STAT SOC B, V34, P187
  • [12] DAUMASDUPORT C, 1992, CURR OPIN NEUROL NEU, V5, P924
  • [13] DAUMASDUPORT C, 1988, CANCER-AM CANCER SOC, V62, P2152, DOI 10.1002/1097-0142(19881115)62:10<2152::AID-CNCR2820621015>3.0.CO
  • [14] 2-T
  • [15] DELAMONTE SM, 1989, AM J PATHOL, V135, P529
  • [16] ELASCO ME, 1980, CANCER, V45, P484
  • [17] CORRELATION OF HISTOPATHOLOGICAL FEATURES AND PROLIFERATIVE POTENTIAL OF GLIOMAS
    GERMANO, IM
    ITO, M
    CHO, KG
    HOSHINO, T
    DAVIS, RL
    WILSON, CB
    [J]. JOURNAL OF NEUROSURGERY, 1989, 70 (05) : 701 - 706
  • [18] GIANGASPERO F, 1983, CANCER, V52, P3220
  • [19] HISTOLOGIC FEATURE RELIABILITY IN CHILDHOOD NEURAL TUMORS
    GILLES, FH
    SOBEL, EL
    LEVITON, A
    TAVARE, CJ
    HEDLEYWHYTE, ET
    BLANK, WF
    FULLING, KH
    BLAIR, JD
    DEMELLO, D
    SOTREL, A
    ORSINI, EN
    ISAACS, H
    RORKE, LB
    HASHIDA, Y
    PRICE, RA
    YUNIS, EJ
    ZAIAS, BW
    BECKER, LE
    DAVIS, RL
    DELEON, GA
    HUFF, D
    MESTRE, G
    SHAMSZADEH, M
    ADELMAN, LS
    AVERILL, RD
    DEGIROLAMI, U
    KLEINMAN, GM
    MORRIS, JH
    RICHARDSON, EP
    SCHOENE, WC
    SMITH, TW
    SOBEL, RA
    KENNEY, C
    MORELLI, D
    SOBEL, E
    [J]. JOURNAL OF NEUROPATHOLOGY AND EXPERIMENTAL NEUROLOGY, 1994, 53 (06) : 559 - 571
  • [20] THE TREATMENT OF OLIGODENDROGLIOMAS AND MIXED OLIGODENDROGLIOMA-ASTROCYTOMAS WITH PCV CHEMOTHERAPY
    GLASS, J
    HOCHBERG, FH
    GRUBER, ML
    LOUIS, DN
    SMITH, D
    RATTNER, B
    [J]. JOURNAL OF NEUROSURGERY, 1992, 76 (05) : 741 - 745