Neurological Surgery 脳神経外科50巻1号

2022年01月発行

特集 Precision Medicine—個別化医療を目指した遺伝子診断と新治療の知見 Ⅱ良性脳腫瘍

Solitary fibrous tumor/hemangiopericytoma

著者： 寺西裕¹ 本郷博貴¹ 宮脇哲¹ 齊藤延人¹

所属機関： ¹東京大学医学部脳神経外科

ページ範囲：P.141 - P.149

Point
・NAB2-STAT6 fusionに伴うSTAT6の核内移行により，STAT6の免疫染色はSolitary fibrous tumor（SFT）/hemangiopericytoma（HPC）に高い感度を示し，両疾患の確定診断に使われる．
・Meningeal SFT/HPCは局所再発率や遠隔転移率が高く，再発・転移イベントは初回診断から10〜20年経過しても発生することが多い．
・組織所見における高いmitotic rateおよび壊死所見は予後不良の有意な因子である．NAB2-STAT6 fusion typeと予後には有意な関連はないが，高いmitotic rateやHPC phenotypeといった組織学的表現型には関連がある．
・局所コントロールにおいて，手術＋術後放射線治療が手術単独よりも予後を改善させるという報告が多い．一方で化学療法のエビデンスレベルは高くなく，主な薬剤としてはアントラサイクリン系薬剤が使用されている．

参考文献

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