| Objective:The growth of tumor depends on cell division, differentiation and death. Recently, apoptosis is becoming a focus on oncology research by virtue of its effect on genesis, development and treatment of the tumor. Apoptosis may be an active anti-neoplastic effect of the tissue. Apoptosis is adjusted as network by a series of related genes including induced gene, Fas, and suppressor genes, bcl-2,survivin. Brain glioma is one of the most common tumor of central nervous system,and the pathogenesis of which is not yet completely clarified. Though a great investigations on apoptosis of brain glioma have been performed by many scholar, the conclusions on relation between apoptosis and the genesis and progress of tumor are not coincident. In this report, apoptosis, proliferation activity and the expression of apoptosis-associated control gene, Fas/APO-1, bcl-2 and survivin, were detected in order to further investigate apoptosis in gliomas and its potential effect on genesis and development of gliomas. We try to find more factors correlated with the genesis, progress and prognosis of the tumor in order to explore new pattern on therapy of glioma.Materials and Methods:50 patients with glioma who underwent operation at the Second Affiliated Hospital, Hebei Medical University from 2000 to 2001 were collected, and which included 24 cases of Male and 26 cases of Female. The range of age was from 8 years old to 72 years old, and included 13 cases of <30 years old, 29 cases of 30-60 years old and 8 cases of >60 years old. The range of disease course was from 1 week to six months. Preoperative chemiotherapy,radiotherapy and immunosuppressive therapy were not performed to all of the patients. All of the patients underwent total surgical treatment in 27 cases, subtotal surgical treatment in 20 cases, and partial surgical treatment in 3 cases. Routinely processed 4% formamint-fixed, paraffin-embedded blocks were archived. Serial sections of 5 μm were cut from the blocks. Then representative sections were stained with H&E in order to confirm the histopathological diagnosis. The tumors were graded and classified according to the WHO(1999) scheme and consisted of 11 cases of WHO grade I [pilocytic astrocytoma(9), and choroid plexus papilloma(2)], 16 cases of WHO grade II [fibrillary astrocytoma (10), protoplasmic astrocytoma (3), oligodendroglioma (2), and ependymoma(1)], 14 cases of WHO grade III [anaplastic astrocytoma (12), and ependymoma (2)], and 9 cases of WHO grade IV [glioblastoma multiforme (6), ependymoblastoma (2) , and medulloblastoma (1)]. 5 cases of normal brain tissue used as control groups were obtained from the patients with brain trauma who underwent inter-decompression. 45 cases (90%) of all patients were followed up in a year, which consisted of 17 cases (37.8%) of death, 28 cases (62.2%) of survival, 20 cases (44.4%) of postoperative radiotherapy, and 30 cases (55.6%) of postoperative chemiotherapy. Apoptotic cells and apoptotic bodies were detected by TdT-mediated-dUTP-X nick end labeling (TUNEL) with in situ Detection kit. Immunohistochemical stains were performed to examine the expression of Fas, Bcl-2, Surviving and PCNA. Buffy staining was showed in nuclear of apoptotic cells and PCNA positive cells. Apoptotic index (AI) and proliferative index (PI) was assessed by scoring the percentage of labelled cells in at least five high-power fields (×400). Immunohistochemistry for Fas, Bcl-2 and Survivin revealed yellow or buffy staining in the cytoplasm of positive glioma cells. Semi-quantitative assessment of Fas, Bcl-2 and Survivin expression was based on the mean percentage of positivetumour cells in at least five high-power fields (×400) assigned to one of five categories: 0, <1%; 1, 1-25%; 2, 25-50%; 3, 50-75%; 4, >75%. The intensity of immunostaining was scored as: 1, weak; 2, moderate; 3, intense. In tumours displaying heterogeneous staining, the predominant pattern was considered for scoring. The percentage of positive tumour cells and staining intensity were multiplie...
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