Histologiczne kryteria diagnostyczne oponiaków atypowych (GII WHO) i ich związek z potencjałem proliferacyjnym

• Authors: Mateusz Józefowicz , Wielisław Papierz

Title variants

EN

Histologic features and MIB-1/Ki67 indices in atypical meningiomas (GII WHO)

• Languages of publication: PL

Abstracts

PL

Oponiaki atypowe zostały zdefiniowane w klasyfikacji WHO jako nowotwory charakteryzujące się histologicznie bądź aktywnością mitotyczną o wartości 4-20 mitoz/10 HPF, bądź co najmniej trzema spośród pięciu następujących cech: gęstokomórkowe utkanie, małe komórki z przesuniętym na korzyść jądra współczynnikiem „jądrowo-cytoplazmatycznym”, jądro z wyraźnym jąderkiem, brak struktur cytoarchitektonicznych (ang. patternless or sheet-like growth) i ogniska martwicy. Oznacza to, że guzy ukazujące mikroskopowo jedną, a nawet dwie spośród wymienionych cech należy zaliczyć, mimo tych nieprawidłowości, do grupy oponiaków łagodnych (GI WHO). Celem przeprowadzonych badań było poszukiwanie w grupie pięciu kryteriów diagnostycznych oponiaków atypowych wg WHO takich cech histologicznych, które w największym stopniu korelują z wartością indeksu proliferacyjnego tych nowotworów. Materiał badawczy obejmował 65 oponiaków atypowych oraz 59 oponiaków łagodnych, wykazujących przynajmniej jedną cechę histologiczną charakterystyczną dla oponiaków atypowych, wybranych spośród 240 archiwalnych przypadków z lat 2004-2011. Wszystkie nowotwory zostały ocenione pod względem pięciu histologicznych kryteriów diagnostycznych dla oponiaków atypowych oraz liczby mitoz na dziesięć pól widzenia. We wszystkich badanych guzach wykonano reakcję immunohistochemiczną z przeciwciałem MIB-1. Indeks proliferacyjny (PI) obliczono za pomocą komputerowego analizatora obrazu. Uzyskane wyniki poddano analizie statystycznej. W wyniku przeprowadzonych badań stwierdzono związek PI z ogniskami martwicy, wyraźnymi jąderkami, brakiem układów cytoarchitektonicznych charakterystycznych dla oponiaków GI WHO, obecnością drobnych komórek ze zwiększonym stosunkiem jądrowo-cytoplazmatycznym oraz liczbą cech histologicznych.

EN

Atypical meningiomas are defined according WHO criteria as tumours characterized by: increased mitotic activity or three or more of the following histologic features: increased cellularity, small cells with a high nuclear/cytoplasmic ratio, prominent nucleoli, patternless or sheet like growth, and foci of “spontaneous” or “geographic” necrosis. It means, that those meningiomas which reveal only one or even two from above mentioned features are, according to WHO classification, still consistent with diagnosis of benign (GI WHO) tumours. Histologic slices from 65 atypical meningiomas were investigated and presence of each from those diagnostic histologic criteria which were mentioned above, were taken to account. Additionally, in the same way 59 benign meningiomas, which showed one or two histologic features char-acteristic for atypical type of the tumours, were analysed. In all cases immunohistochemical reaction with MIB-1 antibody was carried out and proliferating indices (PI) were established using image analysis computer system. Correlation between histologic criteria for atypical meningiomas and proliferating indices of the tumours was statistically estimated. We found a significant relationship between PI and mitotic activity, necrosis, small cells changes, patternless growth, nucleolies and number of histologic features that tumors present.

Keywords

EN

atypical meningiomas; benign meningiomas; histologic features; indeks proliferacyjny; kryteria histologiczne; oponiaki atypowe; oponiaki łagodne; proliferative index

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Aktualności Neurologiczne
• Year: 2012
• Volume: 12
• Issue: 2
• Pages: 104-128

Contributors

author

Mateusz Józefowicz

• Zakład Patomorfologii Katedry Patomorfologii Uniwersytetu Medycznego w Łodzi

author

Wielisław Papierz

• Zakład Patomorfologii Katedry Patomorfologii Uniwersytetu Medycznego w Łodzi

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