CAJ | 학술논문

目的：探讨胶质母细胞瘤的临床发病特点、病理学特点、影像学特点、诊断及鉴别诊断，进一步为临床治疗提供有效的参照。方法对2002年1月至2012年12月期间收治并获得组织病理学诊断的胶质母细胞瘤患者标本242例，应用HE染色、免疫组化等方法进行病理学特征观察，并结合CT和MR检查的影像特点进行综合分析。结果位于大脑229例，小脑9例，脑干2例，椎管2例；肿瘤所发生的部位直接影响到患者的主要症状表现：位于大脑半球主要表现为头痛、呕吐、脑膜刺激征、癫痫发作等；病变位于小脑主要表现为头晕、共济失调或行走不稳；椎管内肿瘤常表现为感觉运动障碍。免疫组化显示胶质纤维酸性蛋白（GFAP）和波形蛋白（vimentin）均呈强弱不等的阳性，Ki-67、CD34均高表达，其它标记物表达各不相同。 CT和MR检查示界限不清的占位性病变常伴有出血、坏死和囊性变，增强扫描呈不规则环状强化。结论胶质母细胞瘤额叶、颞叶高发，肿瘤大小有逐年增加的趋势，恶性程度高，进展快，易复发。
목적：탐토효질모세포류적림상발병특점、병이학특점、영상학특점、진단급감별진단，진일보위림상치료제공유효적삼조。방법대2002년1월지2012년12월기간수치병획득조직병이학진단적효질모세포류환자표본242례，응용HE염색、면역조화등방법진행병이학특정관찰，병결합CT화MR검사적영상특점진행종합분석。결과위우대뇌229례，소뇌9례，뇌간2례，추관2례；종류소발생적부위직접영향도환자적주요증상표현：위우대뇌반구주요표현위두통、구토、뇌막자격정、전간발작등；병변위우소뇌주요표현위두훈、공제실조혹행주불은；추관내종류상표현위감각운동장애。면역조화현시효질섬유산성단백（GFAP）화파형단백（vimentin）균정강약불등적양성，Ki-67、CD34균고표체，기타표기물표체각불상동。 CT화MR검사시계한불청적점위성병변상반유출혈、배사화낭성변，증강소묘정불규칙배상강화。결론효질모세포류액협、섭협고발，종류대소유축년증가적추세，악성정도고，진전쾌，역복발。
Objective To analyze the clinical characteristics , pathological features , image fea-tures, diagnosis and differential diagnosis of glioblastoma and to provide effective references for clinical treatment .Methods During the period from January 2002 to December 2012 , 242 ca-ses of glioblastoma were collected and analyzed with HE and immunohistochemical staining .The image features of CT and MR were also analyzed .Results The brain were 239 cases, the cer-ebellum were 9 cases, brainstem was 2 cases, spinal were 2 cases.The tumor site of occur-rence influenced the patients ’ main symptoms.The clinical symptoms of the cases were head-ache,vomiting, meningeal irritation, seizures in cerebral hemispheres and dizziness , ataxia or unsteady gait in the cerebellum .Spinal tumor usually presented sensorimotor disorder .Immu-nohistochemical study showed unequally positive staining for GFAP and vimentin .The Ki-67 and CD34 were highly expressed .The expression rates of other tumor markers were different . The CT and MR scanning showed occupying lesions with hemorrhage , necrosis and cystic de-generation .The irregular circularity enhancement was showed after enhancement scanning . Conclusion The incidence of frontal lobe and temporal lobe are high , and there is a rising trend of tumor size .The malignant degree of glioblastoma is very high , its progression is rapid , and it is easy to relapse .