Krampla Wolfgang, Newrkla Stephan, Pfisterer Wolfgang, Jungwirth Susanne, Fischer Peter, Leitha Thomas, Hruby Walter, Tragl Karl Heinz
Department of Radiology, Danube Hospital, Vienna, Austria.
Cancer. 2004 Mar 15;100(6):1208-12. doi: 10.1002/cncr.20088.
The prevalence of clinically silent intracranial tumors in specific populations is poorly researched. It is known that, in advanced age groups, the number of clinically manifest meningiomas constitute a small proportion of the actual number of cases. The goals of the current study were to determine the frequency of asymptomatic patients with meningioma in advanced age and to identify risk factors for meningiomas in this population.
Between May 2000 and November 2002, 532 probands from a specifically defined geographic area of Vienna who were age 75 years underwent a magnetic resonance imaging scan of the brain and were evaluated for the presence of a space-occupying mass. All probands were examined clinically and neurologically as well as by a neuropsychiatrist. The patients' medical histories were carefully documented with regard to previous diseases, medication, and lifestyle, as were their laboratory reports. The collected data were correlated and similarities among subjects with meningioma were determined.
Nine meningiomas that were unknown until the time of investigation were observed among the 318 women included in the trial (corresponding to a calculated prevalence of 2800/100,000 clinically silent meningiomas in 75-year-old women). No tumors were found among men. Associated clinical changes or deficits were not observed in any subject. Apart from advanced age and female gender, no other accepted or well known risk factors were observed in the tumor patients.
Clinically quiescent meningiomas in the elderly female population were more common than was believed to be the case to date. Known and influenceable risk factors were found to be less important than age and gender. The high frequency of this lesion should be considered when deciding on the treatment of patients with incidentally discovered, clinically quiescent meningiomas.
特定人群中临床无症状颅内肿瘤的患病率研究较少。众所周知,在老年人群中,临床表现出的脑膜瘤数量在实际病例数中占比很小。本研究的目的是确定老年无症状脑膜瘤患者的频率,并识别该人群中脑膜瘤的危险因素。
2000年5月至2002年11月期间,对来自维也纳特定地理区域的532名75岁的先证者进行了脑部磁共振成像扫描,并评估是否存在占位性肿块。所有先证者均接受了临床、神经学以及神经精神科医生的检查。仔细记录了患者的病史,包括既往疾病、用药情况和生活方式,以及他们的实验室报告。对收集的数据进行关联分析,并确定脑膜瘤患者之间的相似性。
在纳入试验的318名女性中,观察到9例在调查时才发现的脑膜瘤(相当于75岁女性中临床无症状脑膜瘤的计算患病率为2800/100,000)。男性中未发现肿瘤。在任何受试者中均未观察到相关的临床变化或缺陷。除了高龄和女性性别外,在肿瘤患者中未观察到其他公认或知名的危险因素。
老年女性人群中临床静止的脑膜瘤比迄今认为的更为常见。发现已知且可影响的危险因素不如年龄和性别重要。在决定对偶然发现的临床静止脑膜瘤患者进行治疗时,应考虑到这种病变的高发生率。