小脑幕上无症状脑膜瘤的临床特征分析(附163例报告)  

Analysis of clinical characteristics of asymptomatic supratentorial meningiomas:a report of 163 cases

作　　者：杨明煦 吕一帆 邓宇轩 杜超 于兰冰[1] 任同[1] 张扬[1] 初君盛[1] 郝淑煜[1] 季楠[1] Yang Mingxu;Lyu Yifan;Deng Yuxuan;Du Chao;Yu Lanbing;Ren Tong;Zhang Yang;Chu Junsheng;Hao Shuyu;Ji Nan(Neurosurgery Center,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院神经外科学中心,北京100070

出　　处：《中华神经外科杂志》2024年第6期553-558,共6页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金(81872052)。

摘　　要：目的探讨小脑幕上无症状脑膜瘤的临床特征.方法回顾性分析2019年1月至2023年8月于首都医科大学附属北京天坛医院神经外科学中心确诊的无症状脑膜瘤患者的临床资料,共163例,其中122例为手术治疗者,41例为于门诊随访观察者.观察患者的性别、年龄分布,肿瘤部位、大小,组织病理学类型、世界卫生组织(WHO)分级等.结果163例患者中,男51例,女112例,男女比例为1.0:2.2;发病年龄为(53.25±10.75)岁(22~80岁),其中50~59岁患者的占比最高(41.72%,68例),其次为60~69岁患者(22.09%,36例);男、女患者的年龄差异无统计学意义(P=0.127).肿瘤位于大脑凸面最多见,占73.62%(120例),其次为矢状窦旁,占16.56%(27例),而位于大脑镰旁、脑室、小脑幕者均较少见.肿瘤体积的M(Q_(1),Q_(3))为6.08(1.87,15.78)cm^(3).行手术切除的122例患者中,WHO 1级97例(79.51%)、2级21例(17.21%)、3级4例(3.28%);组织病理学类型中以移行型(36.07%,44例)、纤维型(25.41%,31例)及内皮型(17.21%,21例)多见;纤维型脑膜瘤的分布部位最为广泛(各部位均可见),其次为移行型和内皮型脑膜瘤.122例患者中,术后21例(17.20%)发生手术相关的并发症,其中WHO 1级、2级、3级患者分别占8.20%(10例)、6.56%(8例)、2.46%(3例).结论初步观察显示,小脑幕上无症状脑膜瘤可能与脑膜瘤的整体特征存在一定差异.Objective To explore the clinical characteristics of supratentorial asymptomatic meningiomas.Methods A total of 163 patients with asymptomatic meningiomas diagnosed in the Neurosurgery Center of Beijing Tiantan Hospital,Capital Medical University from January 2019 to August 2023 were retrospectively collected,of which 122 were surgically treated and 41 were outpatients undergoing follow-up.We documented the patient's gender,age distribution,tumor location,size,histopathological type,World Health Organization(WHO)grade,etc.Results Among the 163 patients,there were 51 males and 112 females,with a male-to-female ratio of 1.0:2.2;the age of onset was 53.25±10.75 years old(22-80 years old),and patients aged 50-59 accounted for the highest proportion(68 cases,41.72%),followed by 60 to 69 years old(36 cases,22.09%);the age difference between male and female patients was not statistically significant(P=0.127).Tumors located on the convex surface of the brain were most common,accounting for 73.62%(120 cases),followed by the parasagittal sinus,accounting for 16.56%(27 cases).Tumors adjacent to the falx cerebri,within the ventricular system,and supra-tentorium cerebelli were less frequently observed.The M(Q_(1),Q_(3))of the tumor volume was 6.08(1.87,15.78)cm3.Among the 122 patients who underwent surgical resection,97 cases(79.51%)were WHO grade 1,21 cases(17.21%)were grade 2,and 4 cases(3.28%)were grade 3.The predominant histopathological types were transitional(44 cases,36.07%),fibroblastic(31 cases,25.41%),and meningothelial(21 cases,17.21%),with fibroblastic meningiomas presenting the most widespread distribution across different locations,followed by transitional and meningothelial types.Postoperative complications occurred in 21 cases(17.20%),distributed as 10 cases(8.20%)in WHO grade 1,8 cases(6.56%)in grade 2,and 3 cases(2.46%)in grade 3.Conclusion Initial findings indicate that supratentorial asymptomatic meningiomas may exhibit distinct clinical features compared with the general profile of meningiomas.

关 键 词：脑膜瘤 幕上肿瘤 无症状疾病 疾病特征 

分 类 号：R739.45[医药卫生—肿瘤]