Akachi K, Matsumoto M, Yasue M, Nakamura N, Kamada M, Ohno T
Department of Neurosurgery, Tokyo Jikei University, School of Medicine.
No Shinkei Geka. 1991 Dec;19(12):1129-34.
Meningioma includes some clinically malignant cases which grow multifocally or recur rapidly. To develop methodology to distinguish clinically malignant cases, we examined the nuclear DNA of meningiomas by flow cytometry using paraffin-embedded specimens. 52 surgical specimens were studied from 52 cases of meningioma. Among these cases, 3 multiple meningiomas that recurred multifocally within 3 years were included. Malignancy was assessed by the proliferative index (%S + %G2/M) and DNA ploidy of the specimens. Six cases were histologically malignant, while aneuploidy was observed in only 2 (33.3%). No significant correlation was observed when analyzing the 23.9% aneuploidy rate among benign cases. Moreover, three cases of clinically malignant meningiomas were all diploid. In contrast, the proliferative index of 19.82 +/- 9.45% among histologically malignant cases was significantly higher as compared to that for benign cases (11.50 +/- 5.49%). The proliferative index was 15% or more (average 22.02 +/- 6.01%) for patients with clinically malignant meningioma. This was considerably higher than the corresponding value for clinically benign meningiomas. Our analysis indicated that the assessment of benignancy or malignancy of meningioma on the basis of DNA ploidy alone is difficult. The proliferative index so obtained relates significantly to prognosis, apparently providing a useful prognostic assessment.
脑膜瘤包括一些临床恶性病例,这些病例呈多灶性生长或迅速复发。为了开发区分临床恶性病例的方法,我们使用石蜡包埋标本通过流式细胞术检测了脑膜瘤的核DNA。研究了52例脑膜瘤的52个手术标本。其中包括3例在3年内多灶复发的多发性脑膜瘤。通过标本的增殖指数(%S + %G2/M)和DNA倍性评估恶性程度。6例组织学上为恶性,而仅2例(33.3%)观察到非整倍体。分析良性病例中23.9%的非整倍体率时未观察到显著相关性。此外,3例临床恶性脑膜瘤均为二倍体。相比之下,组织学恶性病例的增殖指数为19.82 +/- 9.45%,明显高于良性病例(11.50 +/- 5.49%)。临床恶性脑膜瘤患者的增殖指数为15%或更高(平均22.02 +/- 6.01%)。这大大高于临床良性脑膜瘤的相应值。我们的分析表明,仅根据DNA倍性评估脑膜瘤的良性或恶性是困难的。如此获得的增殖指数与预后显著相关,显然提供了有用的预后评估。