德国学者近日在《神经病学文献》(Archives of Neurology)杂志报道称,弥散性神经胶质瘤不应当被作为病灶性疾病对待,而应该被看作一种涉及整个大脑的系统性疾病。
在一项包括4名弥散性神经胶质瘤患者的研究中,研究人员发现在大脑一些不易引起注意的区域中可以检测到单个的肿瘤细胞,组织学分析发现这些细胞具有多形性及分裂活性。
研究者称,检测弥散性神经胶质瘤的浸润范围长期以来都是个困扰神经病学家的难题,因为以现有技术,单个的神经胶质瘤细胞很难被检测出来。
最近有研究表明,在多数弥散性神经胶质瘤细胞中存在编码异柠檬酸脱氢酶1(IDH1)的基因变异,IDH1变异可引起其编码蛋白质第132位(R132H)上的精氨酸残基置换为组氨酸残基,另外一种单克隆抗体H09可识别R132H突变。该途径可用于检测单个肿瘤细胞。
在该研究中,研究者使用该抗体检测了4名已知有IDH1 R132H突变神经胶质瘤患者的脑组织。发现大脑中多个区域均可检测到神经胶质瘤细胞。
作者称,这种新型IDH1突变和IHC免疫组化方法对有IDH1突变的神经胶质瘤细胞进行原位检测,将对大脑肿瘤的诊断产生重大影响。(生物谷bioon.com)
doi:10.1001/archneurol.2011.2910
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Addressing Diffuse Glioma as a Systemic Brain Disease With Single-Cell Analysis
Felix Sahm, MD; David Capper, MD; Astrid Jeibmann, MD; Antje Habel; Werner Paulus, MD; Dirk Troost, MD; Andreas von Deimling, MD.
Objective To analyze infiltration patterns of IDH1 mutant diffuse gliomas into the brain by identification of single tumor cells applying an antibody specific to mutant IDH1 R132H protein.
Design Immunohistochemical analysis.
Setting University hospital.
Patients Whole-brain and hemisphere sections of 4 patients diagnosed with diffuse glioma.
Results Tumor cells were identified in areas that appeared inconspicuous macroscopically and at histological analysis with respect to cellularity, cellular pleomorphism, or mitotic activity in all cases.
Conclusion Detection of single tumor cells throughout the brain demonstrates diffuse glioma to represent systemic brain disease.