著者

中村 光利 山田 修一 松田 良介 杉本 正 中瀬 裕之

出版者

Kinki Brain Tumor Pathology Conference

雑誌

Neuro-Oncologyの進歩 (ISSN:18800742)

巻号頁・発行日

vol.19, no.1, pp.12-18, 2010-12-01 (Released:2014-04-28)

参考文献数

25

---

The current practice of relying solely on microscopic examinations for histological classification of gliomas and, consequentially, determination of optimal treatment, appears to be insufficient. As a result of the increasing use of molecular markers in tumor classification, there is an emerging emphasis in the genetic profiles of distinct subtypes of glioma. These subtypes of glioma constitute distinct disease entities that evolve through different genetic pathways, and are likely to differ in prognosis and response to therapy. Status of O6-methylguaninemethyltransferase(O6-MGMT) gene is associated with the resistance to temozolomide(TMZ). We have previously found methylation or expression mosaicism of O6-MGMT in gliomas, resulting in problems on tumor sampling and respose to TMZ. An assessment of O6-MGMT methylation mosaicism in heterogeneous glioma may provide a more accurate assessment for the response to TMZ. Oligodendroglioma is recognized as a particular subtype of gliomas that shows remarkable response to chemotherapy(procarbazine + CCNU + vincristine(PCV), making their correct diagnosis important. Loss of heterozygosity(LOH) on chromosomes 1p and 19q is correlated with sensitivity to PCV chemotherapy with increased survival in anaplastic oligodendroglioma cases(WHO grade III). This article reviews biological and molecular approaches to glioma classification that have the potential to increase the efficacy of treatments for these tumors.

著者

中村 光利 竹村 潔

出版者

日本脳神経外科コングレス

雑誌

脳神経外科ジャーナル (ISSN:0917950X)

巻号頁・発行日

vol.5, no.3, pp.238-241, 1996-05-20

---

止血・凝固機能異常などを伴わず,spinal drainageの抜去後に腰椎くも膜下血腫を形成した1例を報告する.症例は47歳の女性で,破裂前文通動脈瘤のクリッピング術後第15病日から8日間spinal drainageを留置した.抜去後から背部痛を訴え,両下肢麻癖を呈した.翌日のMRIで脊髄前面にL1〜L4に及ぶ血腫を認めた.ドレナージ抜去20時間後にL1〜L4の椎弓切除を行い,血腫を全摘出したが,両下肢麻庫は改善しなかった.急性脊髄くも膜下血腫による対麻痺の予後はきわめて不良とされ,早期診断と早期減圧が必要であると考えられた.