The nursing of the surgery for the dysembryoplastic neuroepithelial tumors / 中国实用护理杂志

Objective To explore the observation and nursing of the surgery of dysembryoplastic neuroepithelial tumors (DNT) in the function zone of brain.Methods A retrospective analysis of the clinic data of 5 patients receiving the surgery for the dysembryoplastic neuroepithelial tumors (DNT) in the function zone of brain was carried out,the clinical nursing experience was summarized.Results The EEG was re-examined 1 week after surgery.4 cases showed roughly normal EEG,one case with rare slow wave.The re-examined EEG 3 months after surgery suggested 3 cases were normal and 2 cases were almost normal.No epilepsia occurred after 6-month follow-up.Conclusions For DNT patients,microsurgical resection of the tumor is effective and enhancing the patients' perioperative observation and nursing has a significant meaning to increase the success of surgery,reduce complications,promote the rehabilitation of patients and improve the quality of life of patients.

A Case of Angiocentric Glioma with Unusual Clinical and Radiological Features

Angiocentric glioma was recently recognized as a distinct clinicopathological entity in the 2007 World Health Organization classification of tumors of the central nervous system. Typically, it presents with seizure in children and young adults. However, our patient did not have a history of seizure. Seizure did not occur up to 6 months after operation. Although it usually does not have calcification brain magnetic resonance imaging in our patient showed T1-hyperintense and T2-hypointense signals with calcification.

Perfil e prevalência dos tumores primários do sistema nervoso central no Grupo Hospitalar Conceição, de Porto Alegre, RS / Prevalence and histological aspects of primary central nervous system tumors at the Grupo Hospitalar Conceição, Porto Alegre, RS

Introdução: um dos grandes focos da neuropatologia cirúrgica tem sido associar a classificação dos tumores, baseada em achados histopatológicos, com dados clínicos e imuno-histoquímicos a fim de determinar entidades clínico-patológicas. Avanços nas técnicas de neuroimagem permitem, atualmente, determinar com precisão a localização da lesão e a realização de biópsias em múltiplas áreas deste grupo heterogêneo de tumores. Com o objetivo de estimar a associação entre tipo histológico e topografia, os autores descrevem todos os casos de tumores primários do sistema nervoso central avaliados no Hospital Conceição. Metodologia: foram avaliados 912 casos distintos de tumores primários do sistema nervoso central, entre 1995 e 2009, no laboratório de patologia do Grupo Hospitalar Conceição. Os autores descrevem os tipos histológicos encontrados e sua associação com topografia, idade, sexo e achados imuno-histoquímicos. Resultados: os tipos histológicos mais comuns foram o glioblastoma (31,15%), astrocitoma difuso (10,86%) e meningioma (grau I da OMS - 10,75%), com associação destes com a topografia (p=0,001) e a idade dos pacientes (p=0,01). A avaliação imuno-histoquímica foi realizada em 48 casos de neoplasia maligna indiferenciada, sendo que a expressão dos anticorpos determinou a diferenciação tumoral destas lesões, tornando este método fundamental na avaliação deste subgrupo de tumores. Conclusões: o presente estudo sugere a associação entre tipo histológico, idade e topografia em casos de tumores primários do sistema nervoso central

Introduction: One of the major targets of surgical neuropathology has been to associate tumor classification, based on histopathological findings, with clinical and immunohistochemical data in order to determine clinico-pathological entities. Current advances in the neuroimaging techniques allow to accurately determine the location of lesion and to perform biopsies at multiple sites of this heterogeneous group of tumors. In order to assess the association of this histological type with topography, the authors describe all cases of primary tumors of the central nervous system evaluated in the Conceição Hospital. Methods: 912 distinct cases of primary tumors of the central nervous system were evaluated in the laboratory of Pathology of the Grupo Hospitalar Conceição between 1995 and 2009. The authors describe the histological types found and their association with topography, age, sex and immunohistochemical findings. Results: The most common histological types were the glioblastoma (31.15%), diffuse astrocytoma (10.86%) and meningioma (grade I of WHO, 10.75%), with association of these with topography (p=0.001) and patient age (p=0.01). Immunohistochemical evaluation was performed in 48 cases of undifferentiated malignant neoplasia, where antibody expression determined tumor differentiation

Diagnostic value of apparent diffusion coefficient value in prediction of grade for neuroepithelial tumors / 中华放射学杂志

Objective To investigate the predictive value of ADC value in grading of neuroepithelial tumors. Methods The clinical data and images of 70 patients with neuroepithelial tumors pathologically proven were collected and analyzed restrospectively. All the patients were classified into low(WHOⅠ or Ⅱ)and high(WHO Ⅲ or Ⅳ)grade groups which included 40 and 30 cases respectively accroding to the 2007 WHO classification of tumours of the central nervous system. All the patients underwent plain and contrast-enhanced MR scan and DWI before surgery. The minimum ADC(MinADC)value was measured postoperatively on ADC maps. The Ki-67 labeling index(Ki-67 LI)of tumor tissue was determined by immunohistochemistry.MinADC values for two groups were analyzed using student t test, while the age and Ki-67 LI for the two groups was analyzed using Mann-Whitney test(P＜0.05 considered to be significant＝.Also the MinADC valHe and Ki-67 LI were analyzed with Pearson correlation. The receiver operating characteristic analysis was used for evaluation for grading neuroepithelial tumors of the patients using MinADC. Results The mean MinADC value[(1.08±0.31)×10~(-3) mm~2/s]of the low grade group was significantly higher than that[(0.74±0.18)×10~(-3) mm~2/s]of the high grade group(t=5.42,P＜0.05＝,and the Ki-67 LI of the low grade group[0-50%,median 4%]was significantly lower than that[0-75%,median 25%]of the high grade group(U=325.50,P＜0.05＝.There was a negative correlation between MinADC value and Ki-67 LI(r=-0.30,P＜0.05＝.The area under the ROC curve was 0.85,and the cutoff MinADC value of 0.86×10~(-3) mm~2/s for the differentiation between high and low grade neuroepithelial tumors provided the best combination of sensitivity(90.0%)and specificity(77.5%)(receiver operatingcharacteristic analysis).Conclusion MinADC value is helpful for prediction of neuroepithelial tumor grade.

Differential expression of E-cadherin gene in human neuroepithelial tumors

Cadherins are cell-to-cell adhesion molecules that play an important role in the establishment of adherent-type junctions by mediating calcium-dependent cellular interactions. The CDH1 gene encodes the transmembrane glycoprotein E-cadherin which is important in maintaining homophilic cell-cell adhesion in epithelial tissues. E-cadherin interacts with catenin proteins to maintain tissue architecture. Structural defects or loss of expression of E-cadherin have been reported as a common feature in several human cancer types. This study aimed to evaluate the expression of E-cadherin and their correlation with clinical features in microdissected brain tumor samples from 81 patients, divided into 62 astrocytic tumors grades I to IV and 19 medulloblastomas, and from 5 white matter non-neoplasic brain tissue samples. E-cadherin (CDH1) gene expression was analyzed by quantitative real-time polymerase chain reaction. Mann-Whitney, Kruskal-Wallis, Kaplan-Meir, and log-rank tests were performed for statistical analyses. We observed a decrease in expression among pathological grades of neuroepithelial tumors. Non-neoplasic brain tissue showed a higher expression level of CDH1 gene than did neuroepithelial tumors. Expression of E-cadherin gene was higher in astrocytic than embryonal tumors (P = 0.0168). Low-grade malignancy astrocytomas (grades I-II) showed higher CDH1 expression than did high-grade malignancy astrocytomas (grades III-IV) and medulloblastomas (P < 0.0001). Non-neoplasic brain tissue showed a higher expression level of CDH1 gene than grade I malignancy astrocytomas, considered as benign tumors (P = 0.0473). These results suggest that a decrease in E-cadherin gene expression level in high-grade neuroepithelial tumors may be a hallmark of malignancy in dedifferentiated tumors and that it may be possibly correlated with their progression and dissemination.