颅内脊索瘤型脑膜瘤的临床病理特征及预后分析  

Intracranial Chordoid Meningioma: A Clinicopathologic Prognosis Study

作　　者：毛仁玲[1] 钟平[1] 徐健[1] 徐铭[1] 江澄川[1] 

机构地区：[1]复旦大学附属华山医院神经外科,200040

出　　处：《中国临床神经科学》2015年第3期287-291,共5页Chinese Journal of Clinical Neurosciences

摘　　要：目的：探讨脊索瘤型脑膜瘤的临床、病理特征及预后特点。方法回顾性分析22例行手术切除并经病理证实为脊索瘤型脑膜瘤患者的临床资料，应用相应抗体重新染色标记并进行临床疗效随访。结果22例患者中，男性9例、女性13例；平均年龄46.5岁。均未见明确有Castleman综合征表现；病变均系单发，多数位于小脑幕上。病理检查示脊索样基质占20%~80%，淋巴细胞浸润以B细胞为主，细胞增殖标记物（MIB-1）标记指数为2%~10%，平均2.5%。19例患者达全切，3例患者达次全切除。所有患者均获随访，平均随访时间44.0个月，4例患者复发；次全切除与复发相关；复发患者MIB-1标记指数与非复发患者比较差异无统计学意义。结论脊索瘤型脑膜瘤是非典型脑膜瘤的一个少见亚型，具有复发风险，女性略多见；患者缺乏明确的系统性疾病表现，小脑幕上是好发部位，手术切除程度与患者预后相关，MIB-1标记指数预测复发的意义尚难肯定。Aim To discuss the clinicopathological aspects and prognosis of chordoid meningioma （CM） at a single institute.MethodsThe clinical data of the patients with 22 CMs were retrieved from the records of our department. The specimens were stained with hematoxylin-eosin （H-E）. Immunohistochemistry for epithelial membrane antigen （EMA）, vimentin, glial fibrillary acidic protein （GFAP）, leucocyte common antigen （LCA）, CD3, CD10, CD20, CK and S-100 were done and MIB-1 labeling index （MIB-1 LI） was calculated in all cases. The patients’ prognosis was attained by clinic service and telephone interview. ResultsThe 22 patients included 9 males and 13 females with a mean age of 46.5 years old. No systemic manifestations of Castleman’s syndrome were found. The majority of tumors were in the supratentorial compartments. Chordoid elements comprised 20% to 80% of the entire tumor area. The lymphocytic inifltrate was predominantly of B-cell. The MIB-1 LI varied from 2% to 10% （mean 2.5%）. The 22 cases included 19 cases for total removal and 3 cases for subtotal removal. Among all 22 patients had follow-up with the mean follow-up period of 44.0 months. Four patients recurred. Subtotal resection was associated with recurrence. The MIB-1 LI did not show signiifcant difference between the patients with recurrence and＆amp;nbsp;the patients without recurrence （P＆gt;0.05）.Conclusion CM is a rare subtype of meningioma of adults with a risk of recurrence. There is a slight female preponderance in the subtype. There is absence of systemic manifestations and connection with Castleman’s syndrome. Supratentorial location is the most preferred location. Immunohistochemistry is helpful to differentiate CM from other primary tumors. The extent of resection might likely predict the recurrence.

关 键 词：脑膜瘤 脊索瘤型脑膜瘤 颅内 细胞增殖标记物 预后 

分 类 号：R739.45[医药卫生—肿瘤]