脑膜瘤瘤周水肿与肿瘤部位、病理分级和Ki-67的相关性研究  

Correlation study between peritumoral brain edema and tumoral location,pathological grading and Ki-67 expression in meningioma

作　　者：袁军辉[1] 石东付[1] 吕岩松[1] 冀军玲[1] 刘佰运[2] 吴震[2] 

机构地区：[1]三门峡市中心医院神经外科,472000 [2]首都医科大学附属北京天坛医院神经外科,100050

出　　处：《中国微侵袭神经外科杂志》2017年第12期557-561,共5页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的分析脑膜瘤瘤周水肿(PTBE)与肿瘤发生部位、病理分级及Ki-67的关系。方法回顾性分析712例脑膜瘤病人的临床资料,采用统计学分析评估不同条件下PTBE的发生和水肿严重程度差异。结果发生PTBE 358例(50.3%)。非颅底较颅底脑膜瘤PTBE的发生率高(χ~2=14.686,P<0.01),且水肿程度更重(χ~2=16.812,P<0.01)。WHOⅡ级较Ⅰ级脑膜瘤PTBE发生率高(χ~2=32.403,P<0.01),WHOⅢ级较Ⅱ级PTBE发生率高(χ~2=21.356,P<0.05);且不同病理分级的PTBE水肿程度有差异(χ~2=40.482,P<0.01)。在WHOⅠ级脑膜瘤中,血管瘤型、微囊型、分泌型和富于淋巴-浆细胞型4种脑膜瘤总PTBE发生率较其他5种类型脑膜瘤高(χ~2=48.078,P<0.01),且与WHOⅡ、Ⅲ级总PTBE发生率相当(χ~2=3.238,P>0.05)。Ki-67在同级别病理类型中随着PTBE严重程度呈现升高趋势(χ~2=33.359,P<0.01)。Logistic回归分析显示:病理分级、Ki-67表达与PTBE的严重程度成正相关(P<0.01)。结论脑膜瘤PTBE的发生及严重程度可在一定程度上反映肿瘤的恶性程度和Ki-67的表达情况,为临床手术方案、围手术期治疗及术后辅助治疗等提供重要参考。Objective To analyze the relationship between peritumoral brain edema（PTBE） and tumoral location,pathological type,Ki-67 expression in meningioma.Methods Clinical data of 712 patients with meningioma were analyzed retrospectively,and the statistical analysis was used to evaluate the differences of PTBE incidence and severity degree in different situation.Results PTBE occurred in 358 patients（50.3%）.The incidence rate of PTBE in basicranial meningioma was higher than that in non-basicranial meningioma（χ~2= 14.686,P〈 0.01）,and the edema was much more severe,too（χ~2= 16.812,P〈 0.01）.The incidence rate of PTBE in WHO grade Ⅱ was higher than that in WHO grade Ⅰ（χ~2 = 32.403,P〈 0.01）,and the same to WHO grade Ⅲ versus grade Ⅱmeningiomas（χ~2= 21.356,P〈 0.05）,moreover,edema degree showed significant differences between different pathological grades of the tumor（χ~2= 40.482,P 〈0.01）.In addition,the total incidence rate of PTBE in angiomatous type,microcystic type,secretory type and lymphoplasmacyte-rich type meningiomas was much higher than that in the other five pathological types in WHO grade I meningioma（χ~2= 48.078,P〈 0.01）,even was close to the total incidence rate of WHO grade Ⅱ and Ⅲ meningiomas（χ~2 = 3.238,P 〉0.05）.Furthermore,the level of Ki-67 showed an increasing trend with the severity degree of PTBE（χ~2= 33.359,P〈 0.01）,and logistic regression analysis showed a positive correlation between both pathological grading and Ki-67 distribution and the severity of PTBE（P〈 0.01）.Conclusion The incidence and severity of PTBE can reflect the tumor malignancy grade and Ki-67 expression to a certain extent in meningiomas,and can provide a important reference for operative plan,preoperative treatment and postoperative adjuvant therapy.

关 键 词：脑膜瘤 瘤周水肿 肿瘤部位 病理分级 KI-67 

分 类 号：R739.45[医药卫生—肿瘤]