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Hypomethylated X Chromosome Gain and Rare Isochromosome 12p in Diverse Intracranial Germ Cell Tumors 低甲基化X染色体增益和罕见同工染色体12p在颅内生殖细胞肿瘤中的作用
Pub Date : 2002-06-01 DOI: 10.1093/JNEN/61.6.531
Yoshifumi Okada, R. Nishikawa, M. Matsutani, D. Louis
Twenty-five primary intracranial germ cell tumors (11 germinomas, 5 teratomas, 5 mixed teratomas-germinomas, 1 mixed choriocarcinoma-teratoma, 1 yolk sac tumor, 1 mixed yolk sac tumor-teratoma, and 1 embryonal carcinoma; from 24 males and 1 female) were studied by fluorescence in situ hybridization with probes to the X and Y chromosomes, chromosome 12p, the CDKN2A/p16 gene, and chromosome 13q—loci previously noted to be altered in either intracranial or systemic germ cell tumors. An increased number of X chromosomes, typically 1 extra copy, was observed in 23 of 25 cases (92%), with methylation-sensitive PCR demonstrating that the additional X chromosomes were hypomethylated in 13 of 16 (81%) studied tumors. Five cases (20%) had increased copy numbers of 12p (including tumors with isochromosome 12p), and 3 (12%) had 13q loss. No tumors had CDKN2A/p16 deletion or mutation, and 16 of 25 (64%) were positive for p16 expression by immunohistochemistry. Genetic alterations such as isochromosome 12p, 13q loss and CDKN2A/p16 are therefore not common in intracranial germ cell tumors. However, gains of hypomethylated, active X chromosomes occur in nearly all intracranial germ cell tumors, regardless of histological subtype. Along with the observed male predominance of intracranial germ cell tumors and the predisposition in Klinefelter syndrome patients for these lesions, the data argue strongly that sex chromosome aberrations, rather than isochromosome 12p, are integral to intracranial germ cell tumorigenesis
原发性颅内生殖细胞肿瘤25例(生殖细胞瘤11例,畸胎瘤5例,混合性畸胎瘤-生殖细胞瘤5例,混合性绒毛膜癌-畸胎瘤1例,卵黄囊瘤1例,混合性卵黄囊瘤-畸胎瘤1例,胚胎癌1例);研究人员利用荧光原位杂交技术,对X染色体和Y染色体、12p染色体、CDKN2A/p16基因和13q染色体位点进行了研究,这些位点以前在颅内或全身生殖细胞肿瘤中被发现发生了改变。25例中有23例(92%)观察到X染色体数量增加,通常为1个额外拷贝,甲基化敏感PCR显示,16例研究肿瘤中有13例(81%)的额外X染色体低甲基化。5例(20%)12p拷贝数增加(包括同工染色体12p的肿瘤),3例(12%)13q缺失。25例肿瘤中16例(64%)p16免疫组化表达阳性,无CDKN2A/p16缺失或突变。因此,同工染色体12p、13q缺失和CDKN2A/p16等遗传改变在颅内生殖细胞肿瘤中并不常见。然而,低甲基化、活性X染色体的增加几乎发生在所有颅内生殖细胞肿瘤中,无论其组织学亚型如何。随着男性在颅内生殖细胞肿瘤中的优势和Klinefelter综合征患者对这些病变的易感性,这些数据有力地证明了性染色体畸变,而不是同染色体12p,是颅内生殖细胞肿瘤发生的组成部分
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引用次数: 47
Argyrophilic Grain Disease Is a Sporadic 4‐Repeat Tauopathy 嗜银性谷物病是一种散发的4 -重复的牛头病
Pub Date : 2002-06-01 DOI: 10.1093/JNEN/61.6.547
T. Togo, N. Sahara, S. Yen, N. Cookson, T. Ishizawa, M. Hutton, R. de Silva, A. Lees, D. Dickson
Argyrophilic grain disease (AGD) was first reported as an adult-onset dementia, but recent studies have emphasized personality change, emotional imbalance, and memory problems as clinical features of AGD. AGD is characterized by spindle- or comma-shaped argyrophilic grains in the neuropil of entorhinal cortex, hippocampus, and amygdala. Immunohistochemistry with monoclonal antibodies specific to tau isoforms with four (4R) or three (3R) repeats in the microtubule-binding domain showed immunostaining of grains with 4R, but not 3R, tau antibodies, suggesting that AGD was a 4R tauopathy. The tau isoform composition of AGD was confirmed with densitometric analysis of Western blots of sarkosyl-insoluble tau from the medial temporal lobe of AGD brains with a range of concurrent neurofibrillary pathology and compared with Alzheimer controls. The 4R/3R ratio was 1 or less for Alzheimer disease; the 4R/3R ratio was more than 1 for AGD, decreasing with increasing neurofibrillary pathology and demonstrating that insoluble tau in AGD was enriched in 4R tau. The frequency of the extended tau haplotype was not different in AGD compared to other sporadic 4R tauopathies, progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). Furthermore, AGD occurred in PSP and CBD more frequently than in dementia controls, including Alzheimer disease. These results suggest that AGD, PSP and CBD are 4R tauopathies that share common pathologic, biochemical, and genetic characteristics.
嗜银性谷物病(AGD)最初被报道为一种成人发病的痴呆,但最近的研究强调人格改变、情绪失衡和记忆问题是AGD的临床特征。AGD的特征是在内嗅皮质、海马和杏仁核的神经节中出现梭形或逗号形的嗜银颗粒。在微管结合区域具有4个(4R)或3个(3R)重复序列的tau亚型特异性单克隆抗体的免疫组化显示,颗粒中有4R抗体的免疫染色,但没有3R抗体,这表明AGD是一种4R tau病。通过对具有一系列并发神经原纤维病理的AGD脑内侧颞叶的萨科齐不溶性tau蛋白的Western blot密度分析,并与阿尔茨海默病对照组进行比较,证实了AGD的tau亚型组成。阿尔茨海默病的4R/3R比小于等于1;AGD的4R/3R比值大于1,随着神经原纤维病理的增加而降低,表明AGD中不溶性tau在4R tau中富集。与其他散发性4R tau病变、进行性核上性麻痹(PSP)和皮质基底变性(CBD)相比,AGD中扩展tau单倍型的频率没有差异。此外,PSP和CBD中AGD的发生频率高于痴呆对照组,包括阿尔茨海默病。这些结果表明,AGD、PSP和CBD是具有共同病理、生化和遗传特征的4R牛头病。
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引用次数: 240
Colocalization and Fluorescence Resonance Energy Transfer between cdk5 and AT8 Suggests a Close Association in Pre‐Neurofibrillary Tangles and Neurofibrillary Tangles cdk5和AT8之间的共定位和荧光共振能量转移表明前神经原纤维缠结和神经原纤维缠结密切相关
Pub Date : 2002-06-01 DOI: 10.1093/JNEN/61.6.557
Judith L. Sanders, L. Tsai, B. Hyman
Cyclin-dependent kinase 5 (cdk5) is a serine/threonine kinase that, when activated, induces neurite outgrowth. Recent in vitro studies have shown that cdk5 phosphorylates tau at serine 199, serine 202, and threonine 205 and that p25, an activator of cdk5, is increased in Alzheimer disease (AD). Since tau is hyperphosphorylated at these sites in neurofibrillary tangles, we examined brain tissue from patients with AD and normal elderly control cases to determine whether cdk5 and these phosphoepitopes colocalize in neurofibrillary tangles. Adjacent temporal lobe sections were double immunostained with a polyclonal anti-cdk5 and monoclonal AT8 (which recognizes phosphorylated serine 199, serine 202, and threonine 205 in tau) antibodies. A subset of AT8 phosphotau-positive neurons was immunoreactive for cdk5 in entorhinal (area 28) and perirhinal (area 35) cortices and CA1 of the hippocampus. We assessed the ratio of cdk5-positive cells to AT8-positive cells and found that there is a higher degree of colocalization in pre-neurofibrillary tangles as opposed to intraneuronal and extraneuronal neurofibrillary tangles. We further examined colocalization using fluorescence resonance energy transfer. This suggests a close, stable intermolecular association between cdk5 and phosphorylated tau, consistent with phosphorylation of tau by cdk5 in AD brain.
周期蛋白依赖性激酶5 (cdk5)是一种丝氨酸/苏氨酸激酶,当被激活时,可诱导神经突起生长。最近的体外研究表明,cdk5在丝氨酸199、丝氨酸202和苏氨酸205位点磷酸化tau蛋白,cdk5的激活剂p25在阿尔茨海默病(AD)中升高。由于tau蛋白在神经原纤维缠结的这些位点被过度磷酸化,我们检查了AD患者和正常老年对照病例的脑组织,以确定cdk5和这些磷酸化表位是否在神经原纤维缠结中共定位。邻近颞叶切片用多克隆抗cdk5和单克隆AT8(识别tau蛋白中磷酸化的丝氨酸199、丝氨酸202和苏氨酸205)抗体进行双重免疫染色。AT8磷酸化阳性神经元的一部分在嗅内(28区)和嗅周围(35区)皮层和海马CA1区对cdk5有免疫反应。我们评估了cdk5阳性细胞与at8阳性细胞的比例,发现与神经元内和神经元外的神经原纤维缠结相比,神经原纤维缠结存在更高程度的共定位。我们使用荧光共振能量转移进一步检查了共定位。这表明cdk5与磷酸化的tau之间存在密切、稳定的分子间联系,与AD脑中cdk5磷酸化tau一致。
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引用次数: 72
Microsatellite Analysis of Primary and Recurrent Glial Tumors Suggests Different Modalities of Clonal Evolution of Tumor Cells 原发性和复发性胶质肿瘤的微卫星分析表明肿瘤细胞克隆进化的不同方式
Pub Date : 2002-05-01 DOI: 10.1093/JNEN/61.5.396
É. Gömöri, Z. Fülöp, I. Mészáros, T. Dóczi, A. Matolcsy
Gliomas are characterized by highly variable biological behavior. After surgical resection and postoperative therapy they frequently recur with the same or higher-grade histology. Although a number of genetic aberrations have been described in gliomas of different histological types, the molecular mechanisms of the histological and clinical progression are poorly understood. In this study, we performed longitudinal microsatellite and mismatch repair gene analysis in paired samples of primary and recurrent gliomas in order to reveal whether genetic instability is associated with tumor progression. The 7 microsatellite loci of the 7 patients displayed a total of 18 (54.5%) alterations in the primary and 15 (45.5%) alterations in the recurrent gliomas as compared with the corresponding non-neoplastic cells, but no alterations were found in the hMLH1 and hMSH2 genes. These results suggest that microsatellite instability is associated with the development of the primary gliomas rather than with the recurrence or progression, and it is not associated with structural alterations in the hMLH1 or hMSH2 genes. Comparison of the microsatellite patterns in primary and secondary gliomas revealed 4 different modalities of clonal evolution, involving clonal identity, clonal deletion, clonal progression, and different clonality, suggesting that intensive clonal selection may play a central part in the recurrence of gliomas.
胶质瘤的特点是高度可变的生物学行为。在手术切除和术后治疗后,他们经常复发,具有相同或更高级别的组织学。尽管在不同组织学类型的胶质瘤中已经描述了许多遗传畸变,但组织学和临床进展的分子机制尚不清楚。在这项研究中,我们对原发性和复发性胶质瘤的配对样本进行了纵向微卫星和错配修复基因分析,以揭示遗传不稳定性是否与肿瘤进展有关。与相应的非肿瘤细胞相比,7例患者的7个微卫星位点在原发性胶质瘤中共显示18个(54.5%)改变,在复发性胶质瘤中显示15个(45.5%)改变,但在hMLH1和hMSH2基因中未发现改变。这些结果表明,微卫星不稳定性与原发性胶质瘤的发生有关,而不是与复发或进展有关,并且与hMLH1或hMSH2基因的结构改变无关。通过对原发性和继发性胶质瘤的微卫星模式的比较,揭示了胶质瘤的克隆进化有4种不同的模式,包括克隆同一性、克隆缺失、克隆进展和不同的克隆性,表明密集的克隆选择可能在胶质瘤的复发中起核心作用。
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引用次数: 17
Progressive Reduction of Synaptophysin Message in Single Neurons in Alzheimer Disease 阿尔茨海默病单个神经元突触素信息的进行性减少
Pub Date : 2002-05-01 DOI: 10.1093/JNEN/61.5.384
L. Callahan, W. Vaules, P. Coleman
The data presented here examine 2 hypotheses: 1) that viable but vulnerable single neurons remaining in the Alzheimer brain lose synaptic markers, and 2) that the extent of this loss is related to the disease state of these single neurons when disease state is defined by immunoreactivity. We used double immunohistochemistry (IHC) to define neurofibrillary tangle (NFT) and phosphorylation status of tau at selected defined epitopes. This double IHC was combined with quantitative in situ hybridization for message for the synaptic marker, synaptophysin, in 1,127 single hippocampal CA1 pyramidal neurons from 15 Alzheimer disease (AD) and 4 control cases. We found that there is a graded, progressive, decrease of synaptophysin message expressed by single neurons related to immunohistochemical markers of tau status, and that neurons in similar immunohistochemically defined classes show similar losses of synaptophysin message regardless of whether they were sampled from clinical control brains or advanced AD. The resulting conclusions are consistent with a suggestion that differences among clinically defined AD and control status are defined by the numbers of neurons in various disease states.
本文提供的数据检验了两个假设:1)阿尔茨海默氏症大脑中存活但脆弱的单个神经元丢失突触标记;2)当疾病状态由免疫反应性定义时,这种丢失的程度与这些单个神经元的疾病状态有关。我们使用双重免疫组织化学(IHC)来确定选定的确定表位上的神经原纤维缠结(NFT)和tau蛋白的磷酸化状态。该双免疫组化结合定量原位杂交检测了来自15例阿尔茨海默病(AD)患者和4例对照患者的1127个海马CA1锥体神经元突触标记物突触素的信息。我们发现,与tau状态的免疫组织化学标志物相关的单个神经元表达的突触素信息呈分级、进行性减少,并且在免疫组织化学定义的相似类别中,神经元显示出类似的突触素信息丢失,无论它们是来自临床对照脑还是晚期阿尔茨海默病。由此得出的结论与临床定义的AD和控制状态之间的差异是由不同疾病状态下的神经元数量决定的。
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引用次数: 65
Subtle Developmental Abnormalities in the Inferior Olive: An Indicator of Prenatal Brainstem Injury in the Sudden Infant Death Syndrome 下橄榄的细微发育异常:婴儿猝死综合征中产前脑干损伤的一个指标
Pub Date : 2002-05-01 DOI: 10.1093/JNEN/61.5.427
H. Kinney, T. McHugh, K. Miller, R. Belliveau, S. Assmann
Subtle quantitative abnormalities in neuronal populations derived from the rhombic lip (i.e. arcuate nucleus at the ventral medullary surface, external granular layer of the cerebellum) have been reported in victims of the sudden infant death syndrome (SIDS). In this study, we examined the inferior olive, a major rhombic lip derivative, to determine if subtle rhombic lip abnormalities also involve this nucleus in SIDS. We analyzed the number and density of neurons and reactive astrocytes in the inferior olive in 29 SIDS cases and 29 controls. Computer-assisted cell counting procedures were used in sections stained with hematoxylin and eosin/Luxol fast blue. There was a significant difference in the postconceptionally age-adjusted mean for neuronal density between SIDS cases (7,687 ± 255 neurons/mm3) and controls (8,889 ± 255 neurons/mm3) (p = 0.002). The difference in age-adjusted mean neuronal number between SIDS cases (1,932 ± 89 neurons/2 sections) and controls (2,172 ± 89 neurons/2 sections) was marginally significant (p = 0.063). Reactive astrocytes were present in the inferior olive in SIDS cases, but their number, density, and developmental profile were not significantly different from that of control infants dying of diverse known causes. SIDS victims found dead in cribs, beds, and sofas, prone or supine had subtle olivary abnormalities, suggesting that affected infants are at risk in various sleeping situations. We propose that at least some SIDS victims experience intrauterine brainstem injury including the olivo-arcuato-cerebellar circuitry derived from the rhombic lip. These observations provide future directions for SIDS research concerning the role of early insults in pregnancy, the rhombic lip, and the interactions of the ventral medulla and cerebellum in cardioventilatory control.
据报道,婴儿猝死综合征(SIDS)患者的菱形唇(即髓质腹侧表面的弓形核,小脑外颗粒层)衍生的神经元群中存在细微的数量异常。在这项研究中,我们检查了下橄榄,一个主要的菱形唇衍生物,以确定是否微妙的菱形唇异常也涉及小岛屿发展中国家的这个核。我们分析了29例SIDS患者和29例对照组的下橄榄神经元和反应性星形胶质细胞的数量和密度。用苏木精和伊红/Luxol快速蓝染色的切片采用计算机辅助细胞计数程序。SIDS患者的产后年龄校正平均神经元密度(7,687±255个神经元/mm3)与对照组(8,889±255个神经元/mm3)差异有统计学意义(p = 0.002)。SIDS患儿年龄校正后平均神经元数(1,932±89个神经元/2个切片)与对照组(2,172±89个神经元/2个切片)差异有统计学意义(p = 0.063)。反应性星形胶质细胞存在于SIDS病例的下橄榄中,但它们的数量、密度和发育特征与死于各种已知原因的对照婴儿没有显著差异。死在婴儿床、床和沙发上的小岛屿发展中国家的受害者,无论是俯卧还是仰卧,都有轻微的橄榄异常,这表明受影响的婴儿在各种睡眠情况下都有风险。我们认为,至少有一些SIDS患者经历了宫内脑干损伤,包括源自菱形唇的橄榄-弓状-小脑回路。这些观察结果为SIDS的研究提供了未来的方向,包括妊娠早期损伤的作用,菱形唇,以及腹侧髓质和小脑在心血管控制中的相互作用。
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引用次数: 45
MAP‐2e, a Novel MAP‐2 Isoform, Is Expressed in Gliomas and Delineates Tumor Architecture and Patterns of Infiltration MAP‐2e,一种新的MAP‐2亚型,在胶质瘤中表达并描绘肿瘤结构和浸润模式
Pub Date : 2002-05-01 DOI: 10.1093/JNEN/61.5.403
Satoshi O. Suzuki, R. Kitai, Sunhee C. Lee, J. Goldman, B. Shafit-Zagardo
The MAP-2 isoform containing exon 13 (MAP-2e) is expressed in human fetal development as early as 15 gestational weeks and parallels oligodendrocyte maturation. MAP-2e is down-regulated following myelination and is expressed in few cells in the adult central nervous system (CNS). To determine whether CNS tumors express MAP-2e, we screened 122 archival, paraffin-embedded adult and pediatric tumors of the CNS and non-CNS. All oligodendrogliomas were positive and extensive staining was observed in glioblastomas, various malignant gliomas and dysembryoplastic neuroepithelial tumors. MAP-2e was not expressed in non-CNS tumors or neuroblastomas. Thus, neuroectodermal tumors that have glial characteristics express this developmental marker of immature glia. Analysis of oligodendrogliomas demonstrated numerous cell morphologies from round cells with no processes to cells with single or multiple processes. MAP-2e immunostaining also delineated tumor invasion into adjacent gray and white matter, indicating that MAP-2e appears to be a useful marker for examining the infiltration of malignant cells into surrounding tissue.
含有外显子13 (MAP-2e)的MAP-2亚型早在妊娠15周的人类胎儿发育中表达,并与少突胶质细胞成熟平行。MAP-2e在髓鞘形成后下调,在成人中枢神经系统(CNS)的少数细胞中表达。为了确定中枢神经系统肿瘤是否表达MAP-2e,我们筛选了122例存档的、石蜡包埋的成人和儿童中枢神经系统和非中枢神经系统肿瘤。所有少突胶质细胞瘤均呈阳性,胶质母细胞瘤、各种恶性胶质瘤和胚胎发育异常神经上皮瘤均可见广泛染色。MAP-2e在非中枢神经系统肿瘤和神经母细胞瘤中未表达。因此,具有神经胶质特征的神经外胚层肿瘤表达这种未成熟胶质细胞的发育标志。对少突胶质细胞瘤的分析显示了多种细胞形态,从无突的圆形细胞到有单突或多突的细胞。MAP-2e免疫染色还描绘了肿瘤向邻近灰质和白质的浸润,表明MAP-2e似乎是检查恶性细胞浸润周围组织的有用标记。
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引用次数: 40
Identification of Inter‐Species Transmission of Prion Strains 朊病毒种间传播的鉴定
Pub Date : 2002-05-01 DOI: 10.1093/JNEN/61.5.377
T. Baron
The concern of the potential transmission of animal spongiform encephalopathies to humans, which arose as soon as the interspecies transmission of these diseases was recognized, has been reinforced with the emergence of bovine spongiform encephalopathy (BSE) in cattle. Recent experimental findings suggest that the infectious agent causing BSE in cattle can lead to the occurrence of a new form of Creutzfeldt-Jakob disease in humans. These findings help us understand how the transmission to humans of an animal disease may be recognized. This can involve an indirect approach through the analysis of neurodegeneration, either in the disease host, or more specifically, in genetically well-defined experimental hosts to which the disease can be transmitted. Recent experimental studies have also shown that the different molecular features of the abnormal form of the prion protein, which accumulates in the infected tissues, can provide important clues to the relationships between different spongiform encephalopathies. However, a better understanding of the molecular features associated with the specific pathogenic behavior of different strains is required. Complex relationships between the infectious agents involved in spongiform encephalopathies and the disease host can make the recognition of a link between animal prion strains and the human disease difficult to establish.
一旦认识到动物海绵状脑病的种间传播,就会出现对动物海绵状脑病可能传播给人类的担忧,随着牛海绵状脑病(BSE)的出现,这种担忧得到了加强。最近的实验结果表明,在牛中引起疯牛病的传染因子可导致人类发生一种新形式的克雅氏病。这些发现有助于我们了解如何识别动物疾病向人类的传播。这可能涉及通过分析神经退行性变的间接方法,无论是在疾病宿主中,还是更具体地说,在基因明确的实验宿主中,疾病可以传播。最近的实验研究也表明,在感染组织中积累的异常形式的朊病毒蛋白的不同分子特征可以为不同海绵状脑病之间的关系提供重要线索。然而,需要更好地了解与不同菌株特定致病行为相关的分子特征。海绵状脑病所涉及的传染因子与疾病宿主之间的复杂关系,可能使识别动物朊病毒株与人类疾病之间的联系变得困难。
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引用次数: 13
Where Does Parkinson Disease Pathology Begin in the Brain? 帕金森氏病的病理从大脑的哪里开始?
Pub Date : 2002-05-01 DOI: 10.1093/JNEN/61.5.413
K. Del Tredici, U. Rüb, R. D. de Vos, J. Bohl, H. Braak
The substantia nigra is not the induction site in the brain of the neurodegenerative process underlying Parkinson disease (PD). Instead, the results of this semi-quantitative study of 30 autopsy cases with incidental Lewy body pathology indicate that PD in the brain commences with the formation of the very first immunoreactive Lewy neurites and Lewy bodies in non-catecholaminergic neurons of the dorsal glossopharyngeus-vagus complex, in projection neurons of the intermediate reticular zone, and in specific nerve cell types of the gain setting system (coeruleus-subcoeruleus complex, caudal raphe nuclei, gigantocellular reticular nucleus), olfactory bulb, olfactory tract, and/or anterior olfactory nucleus in the absence of nigral involvement. The topographical parcellation of the nuclear grays described here is based upon known architectonic analyses of the human brainstem and takes into consideration the pigmentation properties of a few highly susceptible nerve cell types involved in PD. In this sample and in all 58 age- and gender-matched controls, Lewy bodies and Lewy neurites do not occur in any of the known prosencephalic predilection sites (i.e. hippocampal formation, temporal mesocortex, proneocortical cingulate areas, amygdala, basal nucleus of Meynert, interstitial nucleus of the diagonal band of Broca, hypothalamic tuberomamillary nucleus).
黑质不是帕金森病(PD)中神经退行性过程的诱导部位。相反,这项对30例附带路易体病理的尸检病例进行的半定量研究结果表明,脑PD始于第一个免疫反应性路易神经突和路易小体的形成,这些路易小体位于背侧舌咽-迷走神经复合体的非儿茶酚胺能神经元、中间网状区的投射神经元以及获得系统的特定神经细胞类型(蓝斑-蓝下复合体、尾侧中音核、巨细胞网状核),嗅球,嗅束,和/或前嗅核在没有黑神经受累的情况下。这里描述的核灰色的地形包裹是基于已知的人类脑干的结构分析,并考虑到PD中一些高度易感的神经细胞类型的色素沉着特性。在这个样本和所有58个年龄和性别匹配的对照组中,路易小体和路易神经突没有出现在任何已知的前脑偏爱部位(即海马区、颞叶中皮层、前皮质扣带区、杏仁核、Meynert基底核、Broca对角带间质核、下丘脑结节状核)。
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引用次数: 753
Impact of Genotype and Morphology on the Prognosis of Glioblastoma 基因型和形态学对胶质母细胞瘤预后的影响
Pub Date : 2002-04-01 DOI: 10.1093/JNEN/61.4.321
Matthias C. Schmidt, S. Antweiler, N. Urban, W. Mueller, A. Kuklík, B. Meyer‐Puttlitz, O. Wiestler, D. Louis, R. Fimmers, A. von Deimling
The recognition of molecular subsets among glioblastomas has raised the question whether distinct mutations in glioblastoma-associated genes may serve as prognostic markers. The present study on glioblastomas (GBM) from 97 consecutively sampled adult patients is based on a clinical, histopathological, immunohistochemical, and molecular genetic analysis. Parameters assessed were age at diagnosis, survival, cell type, proliferation, necrosis, microvascular proliferation, sarcomatous growth, lymphocytic infiltration, thromboses, calcifications, GFAP expression, MIB-1 index, loss of heterozygosity (LOH) of the chromosomal arms 1p, 10p, 10q, 17p, 19q and structural alterations in the TP53, EGFR and PTEN genes. As in previous studies, younger age was significantly associated with better survival. Among the molecular parameters, TP53 mutations and LOH10q emerged as favorable and poor prognostic factors, respectively. TP53 mutations were a favorable prognostic factor independent of whether glioblastomas were primary or secondary. LOH1p or 19q, lesions suspected to be over-represented in long term survivors with malignant glioma, were not associated with better survival. However, the combination of LOH1p and LOH19q defined GBM patients with a significantly better survival. Notably, these patients did not exhibit morphological features reminiscent of oligodendroglioma. These findings indicate that genotyping of glioblastoma may provide clinical information of prognostic importance.
胶质母细胞瘤分子亚群的识别提出了一个问题,即胶质母细胞瘤相关基因的不同突变是否可以作为预后标志物。本研究基于临床、组织病理学、免疫组织化学和分子遗传学分析,对97例连续取样的成人胶质母细胞瘤(GBM)进行了研究。评估的参数包括诊断时年龄、生存率、细胞类型、增殖、坏死、微血管增生、肉瘤生长、淋巴细胞浸润、血栓形成、钙化、GFAP表达、mb -1指数、染色体臂1p、10p、10q、17p、19q杂合性缺失(LOH)以及TP53、EGFR和PTEN基因的结构改变。与之前的研究一样,年龄越小生存率越高。在分子参数中,TP53突变和LOH10q分别成为预后的有利因素和不利因素。TP53突变是一个有利的预后因素,与胶质母细胞瘤是原发性还是继发性无关。LOH1p或19q病变被怀疑在恶性胶质瘤的长期幸存者中过度代表,与更好的生存率无关。然而,LOH1p和LOH19q联合使用可显著提高GBM患者的生存率。值得注意的是,这些患者没有表现出少突胶质细胞瘤的形态学特征。这些发现表明,胶质母细胞瘤的基因分型可能为预后提供重要的临床信息。
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引用次数: 207
期刊
JNEN: Journal of Neuropathology & Experimental Neurology
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