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Vol. 10. Issue 5.
Pages 388-392 (January 1999)
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Vol. 10. Issue 5.
Pages 388-392 (January 1999)
IV. Angiogénesis en oligodendrogliomas
IV. Angiogenesis in oligodendrogliomas
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J. Vaquero, M. Zurita, S. Coca
Unidad de Investigación en Neurociencias de la Fundación Mapfre-Medicina, Laboratorio Neuro-oncología experimental, Servicio de Neurocirugía, Clínica Puerta de Hierro, Madrid
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Resumen

En la presente revisión se muestra la experiencia de los autores en el estudio de los patrones de angiogénesis en oligodendrogliomas. Marcando inmunohistoquímicamente el endotelio vascular (CD-34) se aprecia que los oligodendrogliomas malignos muestran un típico patrón glomeruloide de los capilares intratumorales, que contrasta con el aspecto lineal de los capilares correspondientes a los oligodendrogliomas de bajo grado. Cuando se realizan estudios cuantitativos se observa que, al contrario de observaciones descritas en astrocitomas, en oligodendrogliomas de bajo grado (al menos cuado se cumplen las condiciones de haber presentado un índice de Ki-67 inferior a 1% Y haber sido tratados con cirugía y radioterapia) el simple análisis de la densidad vascular no parece constituir un factor pronóstico significativo. Sin embargo, sí se obtiene significación pronóstica cuando se analiza morfométricamente el área endotelial en relación al número de células. Pacientes con tumores que presentaron un índice de superficie vascular (ISV) superior a 15μm2 tuvieron una supervivencia a 5 y 10 años del 50 y 0% respectivamente, frente a una supervivencia del 100 y 71% para pacientes cuyos tumores mostraron un ISV inferior a 15μm2.

Palabras clave:
Oligodendroglioma
Factores pronósticos
Angiogénesis
Summary

The authors show the different patterns of angiogenesis in oligodendrogliomas after inmunohistochemical demonstration of the endothelial marker CD-34. High-grade oligodendrogliomas show a glomeruloid morphology of intratumor vessels. Nevertheless low-grade oligodendrogliomas show a lineal pattern of intratumor vessels. Furthermore, in contrast with previous observations in astrocytomas, the present study suggests that tumor angiogenesis, expressed as number of microvessels in tumor specimens, has no influence on behavior of low-grade oligodendrogliomas. In low-grade oligodendrogliomas treated by surgery and radiotherapy, and showing a Ki-67 index lesser to 1%, a tumor vascular surface index (VSI) was determined as the CD-34 immunostained endothelial surface in μm2 per 1000 tumor cells. Patients with a VSI of less than 15 showed a survival at 5 and 10 years of 100% and 71%, respectively, versus a survival of 50% and 0% for patients presenting a VSI greater than 15 (P<0.05).

These observations suggest the usefulness of the VSI as a long-term prognostic factor in low-grade oligodendroglioma.

Key words:
Oligodendroglioma
Prognostic factors
Angiogenesis

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