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Prenatal Di-methoxyethyl phthalate exposure impairs cortical neurogenesis and synaptic activity in the mice 产前邻苯二甲酸二甲氧基乙酯暴露损害小鼠皮层神经发生和突触活动。
IF 6.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-10-30 DOI: 10.1111/bpa.13221
Moon Yi Ko, Heejin Park, Sun-Hwa Chon, Byoung-Seok Lee, Sin-Woo Cha, Sung-Ae Hyun, Minhan Ka

Di-methoxyethyl phthalate (DMEP) is a well-known environmentally prevalent endocrine disruptor and may be associated with neurodevelopmental disorders including attention deficit/hyperactivity disorder and intellectual disability. However, the regulatory mechanisms leading to these neurodevelopmental disorders are still poorly understood. Here, we demonstrate that prenatal DMEP exposure causes abnormal brain morphology and function in the mice. DMEP (50 mg/kg) was chronically administered to pregnant mice orally once a day starting on embryonic day 0 (E0) to breast-feeding cessation for the fetus. We found that prenatal DMEP exposure significantly reduced the number of neurons in the parietal cortex by impairing neurogenesis and gliogenesis during the developing cortex. Moreover, we found that prenatal DMEP exposure impaired dendritic spine architectures and synaptic activity in the parietal cortex. Finally, prenatal DMEP exposure in mice induces hyperactivity and reduces anxiety behaviors. Altogether, our study demonstrates that prenatal DMEP exposure leads to abnormal behaviors via impairment of neurogenesis and synaptic activity.

邻苯二甲酸二甲氧基乙酯(DMEP)是一种常见的环境内分泌干扰物,可能与神经发育障碍有关,包括注意力缺陷/多动障碍和智力残疾。然而,导致这些神经发育障碍的调节机制仍然知之甚少。在这里,我们证明了产前DMEP暴露会导致小鼠大脑形态和功能异常。DMEP(50 mg/kg)从胚胎第0天(E0)开始每天口服一次,直至停止对胎儿的母乳喂养。我们发现,产前DMEP暴露通过损害发育中皮层的神经发生和胶质生成,显著减少了顶叶皮层的神经元数量。此外,我们发现产前DMEP暴露损害了顶叶皮层的树突棘结构和突触活动。最后,小鼠产前接触DMEP可诱导多动并减少焦虑行为。总之,我们的研究表明,产前DMEP暴露通过神经发生和突触活动受损导致异常行为。
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引用次数: 0
SPI1 activates TGF-β1/PI3K/Akt signaling through transcriptional upregulation of FKBP12 to support the mesenchymal phenotype of glioma stem cells SPI1通过FKBP12的转录上调激活TGF-β1/PI3K/Akt信号传导,以支持神经胶质瘤干细胞的间充质表型。
IF 6.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-10-22 DOI: 10.1111/bpa.13217
Yifu Song, Yaochuan Zhang, Xiaoliang Wang, Xiaodi Han, Mengwu Shi, Ling Xu, Juanhan Yu, Li Zhang, Sheng Han

Glioma stem cells (GSCs) exhibit diverse molecular subtypes with the mesenchymal (MES) population representing the most malignant variant. The oncogenic potential of Salmonella pathogenicity island 1 (SPI1), an oncogenic transcription factor, has been established across various human malignancies. In this study, we explored the association between the SPI1 pathway and the MES GSC phenotype. Through comprehensive analysis of the Cancer Genome Atlas and Chinese Glioma Genome Atlas glioma databases, along with patient-derived GSC cultures, we analyzed SPI1 expression. Using genetic knockdown and overexpression techniques, we assessed the functional impact of SPI1 on GSC MES marker expression, invasion, proliferation, self-renewal, and sensitivity to radiation in vitro, as well as its influence on tumor formation in vivo. Additionally, we investigated the downstream signaling cascades activated by SPI1. Our findings revealed a positive correlation between elevated SPI1 expression and the MES phenotype, which in turn, correlated with poor survival. SPI1 enhanced GSC MES differentiation, self-renewal, and radioresistance in vitro, promoting tumorigenicity in vivo. Mechanistically, SPI1 augmented the transcriptional activity of both TGF-β1 and FKBP12 while activating the non-canonical PI3K/Akt pathway. Notably, inhibition of TGF-β1/PI3K/Akt signaling partially attenuated SPI1-induced GSC MES differentiation and its associated malignant phenotype. Collectively, our results underscore SPI1's role in activating TGF-β1/PI3K/Akt signaling through transcriptional upregulation of FKBP12, thereby supporting the aggressive MES phenotype of GSCs. Therefore, SPI1 emerges as a potential therapeutic target in glioma treatment.

胶质瘤干细胞(GSCs)表现出不同的分子亚型,间充质(MES)群体代表了最恶性的变体。沙门氏菌致病性岛1(SPI1)是一种致癌转录因子,其致癌潜力已在各种人类恶性肿瘤中得到证实。在本研究中,我们探讨了SPI1通路与MES GSC表型之间的关系。通过对癌症基因组图谱和中国胶质瘤基因组图谱神经胶质瘤数据库以及患者来源的GSC培养物的综合分析,我们分析了SPI1的表达。使用基因敲低和过表达技术,我们评估了SPI1对GSC-MES标记物表达、侵袭、增殖、自我更新和体外辐射敏感性的功能影响,以及它对体内肿瘤形成的影响。此外,我们还研究了SPI1激活的下游信号级联。我们的研究结果显示,SPI1表达升高与MES表型呈正相关,而MES表型又与生存率低相关。SPI1在体外增强GSC-MES的分化、自我更新和抗辐射性,在体内促进致瘤性。从机制上讲,SPI1增强了TGF-β1和FKBP12的转录活性,同时激活了非经典的PI3K/Akt途径。值得注意的是,TGF-β1/PI3K/Akt信号传导的抑制部分减弱了SPI1诱导的GSC-MES分化及其相关的恶性表型。总之,我们的研究结果强调了SPI1通过FKBP12的转录上调在激活TGF-β1/PI3K/Akt信号传导中的作用,从而支持GSCs的侵袭性MES表型。因此,SPI1成为神经胶质瘤治疗的潜在治疗靶点。
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引用次数: 0
Society News 社会新闻
IF 6.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-10-17 DOI: 10.1111/bpa.13095
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引用次数: 0
Poly-GA immunohistochemistry is a reliable tool for detecting C9orf72 hexanucleotide repeat expansions Poly-GA免疫组织化学是检测C9orf72六核苷酸重复扩增的可靠工具。
IF 5.8 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-10-10 DOI: 10.1111/bpa.13216
Jordan Carroll, Heather McCann, Glenda M. Halliday, John B. Kwok, Carol Dobson-Stone, Claire E. Shepherd

Poly-GA immunohistochemistry (A) on formalin fixed paraffin embedded cerebellum sections shows a similar distribution to p62 antibody (B) and reliably identifies neuronal cytoplasmic inclusions and neurites in cases with known C9orf72 repeat expansion. This is useful in the research setting where genetic testing has not been performed in life or suitable tissue is not avilable post-mortem.

福尔马林固定石蜡包埋的小脑切片上的Poly-GA免疫组织化学(A)显示出与p62抗体(B)相似的分布,并在已知C9orf72重复扩增的情况下可靠地识别神经元细胞质内含物和轴突。这在研究环境中很有用,因为在生活中没有进行基因检测,或者死后没有合适的组织。
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引用次数: 0
Colocalization of TDP-43 and stress granules at the early stage of TDP-43 aggregation in amyotrophic lateral sclerosis 肌萎缩侧索硬化症TDP-43聚集早期TDP-43和应激颗粒的共定位。
IF 6.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-10-04 DOI: 10.1111/bpa.13215
Fumiaki Mori, Hina Yasui, Yasuo Miki, Tomoya Kon, Akira Arai, Hidekachi Kurotaki, Masahiko Tomiyama, Koichi Wakabayashi

TDP-43 aggregates (skeins and round inclusions [RIs]) are frequent histopathological features of amyotrophic lateral sclerosis (ALS). We have shown that diffuse punctate cytoplasmic staining (DPCS) is the earliest pathologic manifestation of TDP-43 in ALS, corresponding to nonfibrillar TDP-43 located in the rough endoplasmic reticulum. Previous in vitro studies have suggested that TDP-43 inclusions may be derived from stress granules (SGs). Therefore, we investigated the involvement of SGs in the formation of TDP-43 inclusions. Formalin-fixed spinal cords of six ALS patients with a disease duration of less than 1 year (short duration), eight patients with a disease duration of 2–5 years (standard duration), and five normal controls were subjected to histopathological examination using antibodies against an SG marker, HuR. In normal controls, the cytoplasm of anterior horn cells was diffusely HuR-positive. In short-duration and standard-duration ALS, the number of HuR-positive anterior horn cells was significantly decreased relative to the controls. DPCS and RIs were more frequent in short-duration ALS than in standard-duration ALS. The majority of DPCS areas and a small proportion of RIs, but not skeins, were positive for HuR. Immunoelectron microscopy showed that ribosome-like granular structures in DPCS areas and RIs were labeled with anti-HuR, whereas skeins were not. These findings suggest that colocalization of TDP-43 and SGs occurs at the early stage of TDP-43 aggregation.

TDP-43聚集体(骨骼和圆形内含物[RIs])是肌萎缩侧索硬化症(ALS)常见的组织病理学特征。我们已经表明,弥漫性点状细胞质染色(DPCS)是ALS中TDP-43最早的病理表现,对应于位于粗糙内质网中的非纤维TDP-43。先前的体外研究表明,TDP-43内含物可能来源于应力颗粒(SG)。因此,我们研究了SGs在TDP-43夹杂物形成中的作用。福尔马林固定治疗6例病程小于1年的ALS患者的脊髓 年(短期),8名患者的病程为2-5 年(标准持续时间),并且使用针对SG标记HuR的抗体对五个正常对照进行组织病理学检查。在正常对照中,前角细胞的细胞质呈弥漫性HuR阳性。在短时间和标准时间ALS中,HuR阳性前角细胞的数量相对于对照组显著减少。DPCS和RIs在短时间ALS中的发生率高于标准时间ALS。大多数DPCS区域和一小部分RI(但不是骨架)对HuR呈阳性。免疫电子显微镜显示,DPCS区域和RIs中的核糖体样颗粒结构被抗HuR标记,而骨架蛋白则没有。这些发现表明TDP-43和SG的共定位发生在TDP-43聚集的早期阶段。
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引用次数: 0
LATE-NC in Alzheimer's disease: Molecular aspects and synergies 阿尔茨海默病中的LATE-NC:分子方面和协同作用。
IF 5.8 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-10-04 DOI: 10.1111/bpa.13213
Sandra O. Tomé, Klara Gawor, Dietmar Rudolf Thal

Alzheimer's disease (AD) is classically characterized by senile plaques and neurofibrillary tangles (NFTs). However, multiple copathologies can be observed in the AD brain and contribute to the development of cognitive decline. Limbic-predominant age-related TDP-43 encephalopathy neuropathological changes (LATE-NC) accumulates in the majority of AD cases and leads to more severe cognitive decline compared with AD pathology alone. In this review, we focus on the synergistic relationship between LATE-NC and tau in AD, highlighting the aggravating role of TDP-43 aggregates on tau pathogenesis and its impact on the clinical picture and therapeutic strategies. Additionally, we discuss to what extent the molecular patterns of LATE-NC in AD differ from frontotemporal lobar degeneration with TDP-43 pathology (FTLD-TDP) neuropathological changes. Thus, we highlight the importance of tau and TDP-43 synergies for subtyping AD patients, which may respond differently to therapeutic interventions depending on the presence of comorbid LATE-NC.

阿尔茨海默病(AD)的典型特征是老年斑块和神经原纤维缠结(NFT)。然而,在AD大脑中可以观察到多种共病,并导致认知能力下降。与单独的AD病理相比,大多数AD病例中以肢体为主的年龄相关性TDP-43脑病神经病理学变化(LATE-NC)积累,并导致更严重的认知能力下降。在这篇综述中,我们重点关注AD中LATE-NC和tau之间的协同关系,强调TDP-43聚集体在tau发病机制中的加重作用及其对临床情况和治疗策略的影响。此外,我们还讨论了AD中LATE-NC的分子模式与具有TDP-43病理学(FTLD-TDP)神经病理学变化的额颞叶变性的不同程度。因此,我们强调了tau和TDP-43协同作用对AD患者亚型的重要性,AD患者对治疗干预的反应可能不同,这取决于共病LATE-NC的存在。
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引用次数: 0
Enhanced Creutzfeldt-Jakob disease surveillance in the older population: Assessment of a protocol for screening brain tissue donations for prion disease 老年人群中增强的克雅氏病监测:朊病毒病脑组织捐献筛查方案的评估。
IF 6.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-09-28 DOI: 10.1111/bpa.13214
Alexander H. Peden, Adriana Libori, Diane L. Ritchie, Helen Yull, Colin Smith, Lovney Kanguru, Anna Molesworth, Richard Knight, Marcelo A. Barria

Human prion diseases, including Creutzfeldt-Jakob disease (CJD), occur in sporadic, genetic, and acquired forms. Variant Creutzfeldt-Jakob disease (vCJD) first reported in 1996 in the United Kingdom (UK), resulted from contamination of food with bovine spongiform encephalopathy. There is a concern that UK national surveillance mechanisms might miss some CJD cases (including vCJD), particularly in the older population where other neurodegenerative disorders are more prevalent. We developed a highly sensitive protocol for analysing autopsy brain tissue for the misfolded prion protein (PrPSc) associated with prion disease, which could be used to screen for prion disease in the elderly. Brain tissue samples from 331 donors to the Edinburgh Brain and Tissue Bank (EBTB), from 2005 to 2022, were analysed, using immunohistochemical analysis on fixed tissue, and five biochemical tests on frozen specimens from six brain regions, based on different principles for detecting PrPSc. An algorithm was established for classifying the biochemical results. To test the effectiveness of the protocol, several neuropathologically confirmed prion disease controls, including vCJD, were included and blinded in the study cohort. On unblinding, all the positive control cases had been correctly identified. No other cases tested positive; our analysis uncovered no overlooked prion disease cases. Our algorithm for classifying cases was effective for handling anomalous biochemical results. An overall analysis suggested that a reduced biochemical protocol employing only three of the five tests on only two brain tissue regions gave sufficient sensitivity and specificity. We conclude that this protocol may be useful as a UK-wide screening programme for human prion disease in selected brains from autopsies in the elderly. Further improvements to the protocol were suggested by enhancements of the in vitro conversion assays made during the course of this study.

人类朊病毒疾病,包括克雅氏病(CJD),以散发、遗传和后天形式发生。变异型克雅氏病(vCJD)于1996年在英国首次报道,由牛海绵状脑病污染食物引起。有人担心,英国国家监测机制可能会遗漏一些CJD病例(包括vCJD),尤其是在其他神经退行性疾病更普遍的老年人群中。我们开发了一种高度敏感的方案,用于分析尸检脑组织中与朊病毒疾病相关的错误折叠朊病毒蛋白(PrPSc),该方案可用于筛查老年人的朊病毒疾病。根据检测PrPSc的不同原理,对2005年至2022年爱丁堡脑组织库(EBTB)331名捐赠者的脑组织样本进行了分析,对固定组织进行了免疫组织化学分析,并对来自六个脑区的冷冻样本进行了五次生化测试。建立了一种对生化结果进行分类的算法。为了测试该方案的有效性,将包括vCJD在内的几种经神经病理学证实的朊病毒疾病对照纳入研究队列并进行盲法研究。揭盲时,所有阳性对照病例均已正确识别。没有其他病例检测呈阳性;我们的分析没有发现被忽视的朊病毒病病例。我们的病例分类算法对于处理异常生化结果是有效的。一项总体分析表明,仅在两个脑组织区域进行五项测试中的三项,简化的生化方案就具有足够的敏感性和特异性。我们得出的结论是,该方案可能有助于在英国范围内对从老年人尸检中选择的大脑中的人类朊病毒疾病进行筛查。通过加强本研究过程中进行的体外转化测定,建议对方案进行进一步改进。
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引用次数: 0
Tumor-associated astrocytes promote tumor progression of Sonic Hedgehog medulloblastoma by secreting lipocalin-2 肿瘤相关星形胶质细胞通过分泌脂钙蛋白-2促进音速刺猬蛋白髓母细胞瘤的肿瘤进展
IF 6.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-09-18 DOI: 10.1111/bpa.13212
Haishuang Li, Yuqing Liu, Yantao Liu, Luzheng Xu, Ziwen Sun, Danfeng Zheng, Xiaodan Liu, Chen Song, Yu Zhang, Hui Liang, Bao Yang, Xinxia Tian, Jianyuan Luo, Qing Chang

Sonic Hedgehog (SHH) subgroup of medulloblastoma (MB) accounts for about 25% of all subgroups of MB. Tumor microenvironment (TME) may play a key role in the tumor progression and therapeutic resistance. Tumor-associated astrocytes (TAAs) are reshaped to drive tumor progression through multiple paracrine signals. However, the mechanism by which TAAs modulate MB cells remains elusive. Here, we illuminated that TAAs showed a specific and dynamic pattern during SHH-MB development. Most TAAs gathered to the tumor margin during the tumor progression, rather than evenly distributed in the early-stage tumors. We further demonstrated that lipocalin-2 (LCN2) secreted by TAAs could promote the tumor growth and was correlated with the poor prognosis of MB patients. Knocking down LCN2 in TAAs in vitro impeded the proliferation and migration abilities of MB cells. In addition, we identified that TAAs accelerated the tumor growth by secreting LCN2 via STAT3 signaling pathway. Accordingly, blockade of STAT3 signaling by its inhibitor WP1066 and AAV-Lcn2 shRNA, respectively, in TAAs abrogated the effects of LCN2 on tumor progression in vitro and in vivo. In summary, we for the first time clarified that LCN2, secreted by TAAs, could promote MB tumor progression via STAT3 pathway and has potential prognostic value. Our findings unveiled a new sight in reprogramming the TME of SHH-MB and provided a potential therapeutic strategy targeting TAAs.

髓母细胞瘤(MB)的音刺猬(SHH)亚群约占MB所有亚群的25%。肿瘤微环境(TME)可能在肿瘤进展和治疗耐药性中起着关键作用。肿瘤相关星形胶质细胞(TAA)通过多种旁分泌信号被重塑,从而推动肿瘤进展。然而,TAAs调控MB细胞的机制仍然难以捉摸。在这里,我们揭示了TAAs在SHH-MB发育过程中表现出的特定动态模式。在肿瘤进展过程中,大多数 TAAs 聚集在肿瘤边缘,而不是均匀地分布在早期肿瘤中。我们进一步证实,TAAs分泌的脂钙蛋白-2(LCN2)可促进肿瘤生长,并与MB患者的不良预后相关。在体外敲除 TAAs 中的 LCN2 会阻碍 MB 细胞的增殖和迁移能力。此外,我们还发现 TAAs 通过 STAT3 信号通路分泌 LCN2 加速了肿瘤的生长。因此,在 TAAs 中分别使用 STAT3 抑制剂 WP1066 和 AAV-Lcn2 shRNA 阻断 STAT3 信号转导,就能减弱 LCN2 在体外和体内对肿瘤进展的影响。综上所述,我们首次明确了TAAs分泌的LCN2可通过STAT3通路促进MB肿瘤的进展,并具有潜在的预后价值。我们的发现揭示了重编程 SHH-MB TME 的新视角,并提供了针对 TAAs 的潜在治疗策略。
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引用次数: 0
Frontal lobe mass in a 46-year-old woman 一名 46 岁女性的额叶肿块
IF 6.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-09-15 DOI: 10.1111/bpa.13211
Kevin Y. Zhang, Bharat Ramlal, Karisa C. Schreck, Charles G. Eberhart, Calixto-Hope G. Lucas
<p>A 46-year-old woman presented with new onset seizures. Magnetic resonance imaging (MRI) revealed a 4 cm heterogeneously enhancing mass centered in the right posterior frontal lobe with mild perilesional edema and effacement of the adjacent sulci (Figure 1A). The mass was restricted to cortex and hemispheric white matter, with no involvement of deep grey matter or other midline structures. A retrospective review of MRI studies from 3 years prior demonstrated mild FLAIR signal abnormality in the same location.</p><p>The patient underwent craniotomy for resection. Postoperative MRI showed near gross total resection of the mass. The patient declined adjuvant chemotherapy or radiotherapy and was instead treated with intravenous vitamin therapy, hyperbaric oxygen, and additional nutritional supplements. Postoperative imaging at 6 and 12 months demonstrated an enlarging enhancing component at the resection margin (Figure 1B). Re-resection at 12 months following initial surgery confirmed tumor recurrence.</p><p>Histologic sections from the initial surgery revealed a moderately cellular glial neoplasm composed of tumor cells with irregular and hyperchromatic nuclei (Box 1, Figure 2, top row). Foci of microvascular proliferation and necrosis were also seen. The mitotic rate reached up to 6 mitotic figures per 10 high-power fields. Synaptophysin staining highlighted entrapped axons, consistent with an infiltrative growth pattern (Figure 2, middle row). By immunohistochemistry, the neoplastic cells expressed GFAP and OLIG2 but were negative for IDH1 R132H or BRAF V600E mutant protein immunostains. ATRX expression was retained, and p53 labeled only scattered tumor cells.</p><p>Next-generation sequencing studies detected <i>H3F3A</i> p.K27M (variant allele frequency 42%), <i>NF1</i> p.E1192* (85%), and <i>TP53</i> p.E171* (9%) mutations. While the tumor harbored gain of chromosome 7, it lacked chromosome 10 loss, <i>TERT</i> promoter mutation, or <i>EGFR</i> amplification. Retrospective immunohistochemical staining showed diffuse immunoreactivity for H3 K27M mutant protein, along with loss of H3K27me3 expression in tumor cells (Figure 2, bottom row). Methylation profiling performed at NIH/NCI demonstrated a high-confidence match to the “diffuse midline glioma, H3 K27-altered” (DMG) class. Uniform manifold approximation and projection dimensionality reduction analysis also placed the tumor in the “DMG, H3 K27-altered” class.</p><p>“High-grade glioma (HGG), H3 K27M-mutant, not elsewhere classified (NEC)”</p><p>This case represents a rare example of a diffusely infiltrating HGG centered in the cerebral hemisphere harboring <i>H3F3A</i> p.K27M mutation [<span>1</span>] and the first to our knowledge demonstrating an epigenetic signature aligning with “DMG, H3 K27-altered.” Midline location is an essential criterion for the diagnosis of DMG according to the 2021 WHO Classification of Tumors of the Central Nervous System. Perplexingly, this case does not involve
一名 46 岁女性因新发癫痫发作就诊。磁共振成像(MRI)显示,右侧额叶后部中心有一个 4 厘米的异质性强化肿块,周围轻度水肿,邻近沟部有渗出(图 1A)。肿块局限于皮质和半球白质,未累及深部灰质或其他中线结构。患者接受了开颅切除术。术后核磁共振成像显示肿块几乎完全切除。患者拒绝接受辅助化疗或放疗,而是接受了静脉维生素疗法、高压氧和额外的营养补充剂治疗。术后 6 个月和 12 个月的造影显示,切除边缘有增大的增强成分(图 1B)。首次手术的组织学切片显示,肿瘤为中度细胞性胶质瘤,由具有不规则和高色素核的肿瘤细胞组成(方框 1,图 2,最上面一行)。还可见微血管增生和坏死灶。有丝分裂率高达每 10 个高倍视野 6 个有丝分裂图形。突触素染色突出显示了夹带的轴突,与浸润性生长模式一致(图 2,中排)。免疫组化显示,肿瘤细胞表达 GFAP 和 OLIG2,但 IDH1 R132H 或 BRAF V600E 突变蛋白免疫印迹阴性。下一代测序研究检测到 H3F3A p.K27M(变异等位基因频率为 42%)、NF1 p.E1192*(85%)和 TP53 p.E171*(9%)突变。虽然该肿瘤存在 7 号染色体增益,但没有 10 号染色体缺失、TERT 启动子突变或表皮生长因子受体扩增。回顾性免疫组化染色显示,H3 K27M突变蛋白具有弥漫性免疫反应,同时肿瘤细胞中的H3K27me3表达缺失(图2,最下面一行)。NIH/NCI进行的甲基化分析表明,与 "弥漫中线胶质瘤,H3 K27改变"(DMG)类别的匹配可信度很高。统一流形近似和投影降维分析也将该肿瘤归入 "DMG,H3 K27-altered "类。"高级别胶质瘤(HGG),H3 K27M突变,未在别处分类(NEC)"该病例是以大脑半球为中心的弥漫浸润性HGG的罕见病例,携带H3F3A p.K27M突变[1],也是我们所知的第一个显示与 "DMG,H3 K27-altered "一致的表观遗传学特征的病例。根据 2021 年世界卫生组织中枢神经系统肿瘤分类,中线位置是诊断 DMG 的基本标准。令人费解的是,该病例没有涉及任何中线结构,因此不符合传统的 "DMG,H3 K27改变 "的现代诊断标准。因此,尽管该病例的突变和表观遗传学特征与 "DMG,H3 K27改变 "非常吻合,但仍被命名为 "NEC"。此外,虽然该 HGG 包含坏死区和微血管增生灶,且未携带 IDH1 或 IDH2 突变,但在该病例中并未发现 "胶质母细胞瘤,IDH 野生型 "常见的分子改变。有趣的是,虽然H3 K27M突变被广泛认为是 "DMG,H3 K27-altered "的遗传标志,但半球非中线组织学低级别胶质瘤(LGG)携带H3 K27M突变的情况也很少见。与 "DMG,H3 K27-altered "相比,迄今报道的H3 K27M突变的低级别胶质瘤可能表现为弥漫或环形,缺乏微血管增生或坏死,存活率明显较高[2, 3]。相比之下,本病例的组织学发现(有丝分裂率增高、微血管增生和坏死)代表了 HGG 的特征。此外,该病例的短间隔随访成像和再次切除显示肿瘤进展,更符合传统 "DMG,H3 K27 变异 "的侵袭性自然病史。由于病例较少,H3 K27M 突变在半球胶质瘤中的临床意义以及其他组织学特征(生长模式、有丝分裂率和坏死)的预后价值仍不确定。总之,本病例强调了结合临床表现、组织学特征和分子分析对中枢神经系统肿瘤进行综合分类的重要性。
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引用次数: 0
Special Issue: Abstracts of the 20th International Congress of Neuropathology, Berlin, Germany, September 13–16, 2023 特刊:第20届国际神经病理学大会摘要,德国柏林,2023年9月13-16日
IF 6.4 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2023-09-06 DOI: 10.1111/bpa.13194
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引用次数: 0
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Brain Pathology
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