探讨脑膜瘤临床病理特征(附162例临床病理特征分析)  

The clinicopathologic features of meningioma: analysis of clinical and pathological features of 162 cases

作　　者：刘禄[1] 杨娜[1] 刘智[1] 李林丰[1] 夏勤[1] 叶川 刘汝艺 梁鹏[1] 夏涌然 LIU Lu;YANG Na;LIU Zhi;LI Linfeng;XIA Qin;YE Chuan;LIU Ruyi;LIANG Peng;XIA Yongran(Suining Central Hospital,Suining 629000,China)

机构地区：[1]遂宁市中心医院

出　　处：《临床医药实践》2019年第6期450-453,共4页Proceeding of Clinical Medicine

摘　　要：目的:探讨脑膜瘤临床及病理诊断特征。方法:回顾性分析162例脑膜瘤患者临床特征、性别、年龄特点、脑膜瘤病理亚型及鉴别诊断要点,总结脑膜瘤临床病理特征。结果:162例脑膜瘤病例,男43例,女119例。发生于大脑134例(82.72%)。大脑半球凸面发病最高部位为顶叶,共计46例(42.59%),高于大脑凸面其他三个部位(颞叶、额叶、枕叶)。脑膜瘤病理分为8个亚型。肿瘤临床预后分期分级:WHOⅠ级147例(90.74%),WHOⅡ级6例(3.70%),WHOⅢ级9例(5.56%)。脑膜瘤上皮膜抗原(EMA)标记阳性133例(82.10%),脑膜瘤波形蛋白(Vimentin)标记阳性158例(97.53%),因此本组脑膜瘤组织中EMA和Vimentin基本为阳性,脑膜瘤免疫组化辅助诊断中,免疫标记EMA及Vimentin均为最好的辅助诊断标记。结论:脑膜瘤为颅内常见肿瘤,临床表现不具有特异性。肿瘤的最终确诊仍需要病理诊断,脑膜瘤病理组织形态较多,病理亚型复杂,免疫组织化学标记较为特异,可借助免疫组织化学染色进行辅助诊断。脑膜瘤的分级是肿瘤预后的重要指标,病理诊断工作中应严格掌握脑膜瘤病理分级的标准及亚型,为临床治疗及预后判断提供准确参考。Objective:To explore the clinicopathological features of meningioma and study the pathological features of meningioma.Methods:To analyze the clinical features,gender and age characteristics of 162 patients with meningioma,as well as the pathological subtype and differential diagnosis of meningioma,and summarize the clinical pathological features of meningioma.Results:There were 162 cases of meningioma in this study,43 cases in males and 119 cases in females,with a male-to-female ratio of 1∶2.77.There were 134 cases in the brain,accounting for 82.72%of the total.The highest part of the convex surface of the brain hemisphere was the parietal lobe,a total of 46 cases,accounting for 42.59%of the number of the convex surface of the brain hemisphere,higher than the other three parts of the brain convex surface(temporal lobe,frontal lobe,occipital lobe).The pathological subtypes of meningioma are divided into 8 subtypes.Tumor clinical prognosis of stage classification:WHOⅠlevel 147 cases,accounted for 90.74%of the total WHOⅡlevel 6 cases,accounted for 3.7%of the total WHOⅢlevel 9 cases,5.56%of the total.There were 133 cases with positive EMA markers,and the positive rate was 82.1%.There were 158 cases with positive Vimentin markers,and the positive rate was 97.53%.Therefore,EMA and Vimentin were basically positive in this group.Conclusion:Meningioma is a common intracranial tumor with no specific clinical manifestations.The final diagnosis of the tumor still requires pathological diagnosis.There are many pathological histological forms,complex pathological subtypes and specific immunohistochemical markers for the diagnosis of meningioma,which can be assisted by immunohistochemical staining.The grade of meningioma is an important index for the prognosis of tumors,and the criteria and subtypes of the pathological grade of meningioma should be strictly mastered in the pathological diagnosis,providing an accurate reference for clinical treatment and prognosis judgment.

关 键 词：脑膜瘤 临床 病理 诊断 鉴别诊断 

分 类 号：R739.45[医药卫生—肿瘤]