Histological study of chordoma origin from fetal notochordal cell rests
1*Department of Orthopaedic Surgery, Suzhou Municipal Hospital, Affiliated Suzhou Hospital, Nanjing Medical University, Suzhou, Jiangsu Province, China; and †Department of Orthopaedic Surgery, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Study Design:
The histological comparative study was performed on chordoma and notochordal cell rests (NCRs).
Objective:
To understand the histological similarity and homology of chordoma and NCRs, further supplying direct evidence of chordoma origin from NCRs.
Summary Of Background Data:
Although many studies supported the hypothesis that chordoma arise from NCRs, there has been little direct evidence reported to date. Of the base of our previous study, we conducted a comparative histological study among NCRs coexisting in chordoma, fetal NCRs, and chordoma tumor components.
Methods:
Thirty fetal nucleus pulposus and 46 chordoma specimens were harvested, and classic chordoma tumor markers and brachyury expression levels were investigated through immunohistochemical method.
Results:
The fetal NCRs existed in the form of clusters in the center of nucleus pulposus <36 gestational weeks; NCRs coexisting in chordoma specimens consisted of packed cells without extracellular myxoid matrix. Both the above-mentioned NCRs as well as chordoma tumor components showed high sensitivity for classic chordoma tumor makers (epithelial membrane antigen, AE1/AE3, CAM5.2, vimentin, S-100); both kinds of NCRs showed completely negative expression for brachyury, whereas chordoma tumor components demonstrated 100% positivity.
Conclusion:
Our study results supported histological similarity and homology of NCRs coexisting in chordoma and in fetal nucleus pulposus. Brachyury activation probably takes an important role in chordoma tumoregenesis.
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