Vascular Pattern Analysis for the Prediction of Clinical Behaviour in Pheochromocytomas and Paragangliomas

被引:16
作者
Oudijk, Lindsey [1 ]
van Nederveen, Francien [2 ]
Badoual, Cecile [3 ,4 ]
Tissier, Frederique [5 ,6 ]
Tischler, Arthur S. [7 ,8 ]
Smid, Marcel [9 ]
Gaal, Jose [1 ]
Lepoutre-Lussey, Charlotte [3 ,10 ]
Gimenez-Roqueplo, Anne-Paule [3 ,10 ,11 ]
Dinjens, Winand N. M. [1 ]
Korpershoek, Esther [1 ]
de Krijger, Ronald [1 ,12 ]
Favier, Judith [3 ,10 ]
机构
[1] Erasmus MC, Univ Med Ctr, Erasmus MC Canc Inst, Dept Pathol, Rotterdam, Netherlands
[2] PAL Dordrecht, Pathol Lab, Dordrecht, Netherlands
[3] Univ Paris 05, Sorbonne Paris Cite, Fac Med, F-75006 Paris, France
[4] Hop Europeen Georges Pompidou, AP HP, Dept Anatomopathol, F-75015 Paris, France
[5] Univ Paris 06, Sorbonne Univ, Pitie Salpetriere Hosp, AP HP,Dept Pathol, Paris, France
[6] Univ Paris 05, Sorbonne Paris Cite, Inst Cochin, INSERM,CNRS,UMR8104,U1016, F-75006 Paris, France
[7] Tufts Univ, Sch Med, Dept Pathol, Boston, MA 02111 USA
[8] Tufts Med Ctr, Boston, MA USA
[9] Canc Genom Netherlands, Erasmus MC Canc Inst, Dept Med Oncol, Rotterdam, Netherlands
[10] INSERM, UMR970, Paris Cardiovasc Res Ctr, F-75015 Paris, France
[11] Hop Europeen Georges Pompidou, AP HP, Serv Genet, F-75015 Paris, France
[12] Reinier de Graaf Hosp, Dept Pathol, Delft, Netherlands
关键词
TUMOR ANGIOGENESIS; EXPRESSION; GENETICS; BENIGN; KI-67;
D O I
10.1371/journal.pone.0121361
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Pheochromocytomas (PCCs) are neuroendocrine tumors arising from chromaffin cells of the adrenal medulla. Related tumors that arise from the paraganglia outside the adrenal medulla are called paragangliomas (PGLs). PCC/PGLs are usually benign, but approximately 17% of these tumors are malignant, as defined by the development of metastases. Currently, there are no generally accepted markers for identifying a primary PCC or PGL as malignant. In 2002, Favier et al. described the use of vascular architecture for the distinction between benign and malignant primary PCC/PGLs. The aim of this study was to validate the use of vascular pattern analysis as a test for malignancy in a large series of primary PCC/PGLs. Six independent observers scored a series of 184 genetically well-characterized PCCs and PGLs for the CD34 immunolabeled vascular pattern and these findings were correlated to the clinical outcome. Tumors were scored as malignant if an irregular vascular pattern was observed, including vascular arcs, parallels and networks, while tumors with a regular pattern of short straight capillaries were scored as benign. Mean sensitivity and specificity of vascular architecture, as a predictor of malignancy was 59.7% and 72.9%, respectively. There was significant agreement between the 6 observers (mean kappa = 0.796). Mean sensitivity of vascular pattern analysis was higher in tumors > 5 cm (63.2%) and in genotype cluster 2 tumors (100%). In conclusion, vascular pattern analysis cannot be used in a stand-alone manner as a prognostic tool for the distinction between benign and malignant PCC, but could be used as an indicator of malignancy and might be a useful tool in combination with other morphological characteristics.
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页数:10
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