背景：神经母细胞瘤是婴幼儿和儿童最常见的实体肿瘤之一，靶向肿瘤干细胞的治疗能够有望从根本上治愈肿瘤，但是肿瘤干细胞数量较少，并具有抗凋亡、抗放化疗能力等，导致其对于放疗、化疗并不敏感。 目的：探究干细胞标志物CD133在神经母细胞瘤中的表达及其临床意义。 方法：收集2004年6月至2014年2月新疆医科大学第一附属医院小儿外二科诊治的58例神经母细胞瘤患儿临床资料，其中神经母细胞瘤患儿46例，节细胞母细胞瘤患儿12例，通过免疫组织化学分析法分析所有患儿肿瘤组织中的CD133表达水平，并研究神经母细胞瘤的病理分型、INSS分期、术后存活时长与CD133表达水平之间存在的联系。 结果与结论：共有22例(48%)神经母细胞瘤患儿CD133表达为阳性，有4例(33%)节细胞母细胞瘤患儿CD133表达阳性，肿瘤细胞胞浆为CD133主要表达部位。肿瘤组织各临床分期的CD133阳性率差异明显，其中1，2期为21%，3，4期为64%，4S 期为36.4%，差异有显著性意义(P=0.011)；组织分型为预后良好型患儿CD133阳性率为29%，明显低于预后不良组织型患儿(57%)，差异有显著性意义(P=0.031)。CD133阴性患儿生存周期显著长于CD133阳性患儿(P <0.05)。结果表明干细胞标志物CD133的表达与神经母细胞瘤发生、发展、转归有密切联系，在评估患儿术后存活时长、改进该病的诊断和治疗等方面具有重要意义。%BACKGROUND:Neuroblastoma is the most common solid tumor in infants and children. Targeting cancer stem cel therapy can be expected to cure cancer radicaly, but because of smal number, anti-apoptotic and anti-chemotherapy capacity, cancer stem cels are not sensitive to the radiotherapy and chemotherapy. OBJECTIVE:To explore the expression of stem cel marker CD133 in neuroblastoma and its clinical significance. METHODS:Fifty-eight children with neuroblastoma admitted at Department of Pediatric Surgery, the First Affiliated Hospital of Xinjiang Medical University, China from June 2004 to February 2014 were enroled, including 46 cases of neuroblastoma and 12 cases of ganglion neuroblastoma. Then, the expression level of CD133 was analyzed by immunohistochemistry method, and the relationship between pathological types, International Neuroblastoma Staging System stage, survival time after surgery and the expression level of CD133 was explored. RESULTS AND CONCLUSION:There were 22 cases (48%) of neuroblastoma positive for CD133, and 4 cases (33%) of ganglion neuroblastoma positive for CD133. CD133 mainly expressed in the tumor cel cytoplasm. The expression rates of CD133 in different clinical stages were significantly different (P=0.011), which were 21% for stages 1 and 2, 64% for stages 3 and 4, 36% for stage 4S. And the positive rates of CD133 between patients with good prognosis and patients with poor prognosis were significantly different (P=0.031), which were 29% and 57%, respectively. The life cycle of CD133-negative patients was significantly longer than that of CD133-positive infants (P < 0.05). There were tightly connections between CD133 and the occurrence, development, and prognosis of neuroblastoma, and thus, CD133 is of great significance to assess the survival time after surgery and improve of the diagnosis and treatment of neuroblastoma.
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