Kamei Y, Watanabe M, Nakayama T, Kanamaru K, Waga S, Shiraishi T
Department of Neurosurgery, Mie University School of Medicine, Tsu, Japan.
J Neurooncol. 2000;46(3):205-13. doi: 10.1023/a:1006440430585.
Recurrence is an important factor for prognosis of meningioma patients, this also occurring with some lesions diagnosed histopathologically as benign. To analyze their relationships with clinicopathological factors, p53 and p21WAF1/CIP1 immunoreactivity, 80 meningiomas were classified into four groups with regard to the World Health Organization (WHO) histological classification and recurrence: 40 cases of Group I (typical type)-NR (no recurrence); five cases of Group I-R (recurrence); 20 cases of Group II (atypical or anaplastic type)-NR and 15 cases of Group II-R. Micronecrosis was detected in 25% of Group II-NR and 73.3% of Group II-R (P = 0.007, odds ratio (OR) = 8.25, 95% confidence interval (CI) = 1.79-38.01). Patients receiving radiation therapy had a lower risk of recurrence (P = 0.041, OR = 0.20, 95% CI = 0.05-0.85). Immunoreactivity for p53 protein was positive in 22% of Group I and 54% or Group II (P = 0.005), and in 80% of Group I-R and 15% of Group I-NR (P = 0.006, OR = 22.7, 95% CI = 2.15-239.4). p21WAF1/CIP1 protein was detected in 22% of Group I and 48% of Group II (P = 0.017), but with no link to recurrence. Multivariate analysis also showed p53 immunoreactivity in Group I (benign lesions) and micronecrosis in Group II (atypical/anaplastic meningiomas) to be strong prognostic factors for recurrence (P < 0.05). These results indicate that p53 immunoreactivity and micronecrosis can help predicting recurrence of meningiomas.
复发是脑膜瘤患者预后的一个重要因素，一些经组织病理学诊断为良性的病变也会出现复发。为了分析它们与临床病理因素、p53和p21WAF1/CIP1免疫反应性之间的关系，根据世界卫生组织（WHO）组织学分类和复发情况，将80例脑膜瘤分为四组：I组（典型型）-无复发（NR）40例；I组-复发（R）5例；II组（非典型或间变型）-无复发20例，II组-复发15例。在II组-NR中，25%检测到微坏死，II组-R中73.3%检测到微坏死（P = 0.007，优势比（OR）= 8.25，95%置信区间（CI）= 1.79 - 38.01）。接受放射治疗的患者复发风险较低（P = 0.041，OR = 0.20，95% CI = 0.05 - 0.85）。p53蛋白免疫反应性在I组中22%呈阳性，II组中54%呈阳性（P = 0.005），在I组-R中80%呈阳性，I组-NR中15%呈阳性（P = 0.006，OR = 22.7，95% CI = 2.15 - 239.4）。p21WAF1/CIP1蛋白在I组中22%被检测到，II组中48%被检测到（P = 0.017），但与复发无关。多因素分析还显示，I组（良性病变）中的p53免疫反应性和II组（非典型/间变型脑膜瘤）中的微坏死是复发的强预后因素（P < 0.05）。这些结果表明，p53免疫反应性和微坏死有助于预测脑膜瘤的复发。
