GammaWest Cancer Services, Salt Lake City, UT, USA.
J Neurooncol. 2010 Sep;99(3):393-405. doi: 10.1007/s11060-010-0343-1. Epub 2010 Aug 26.
Atypical (WHO grade II) meningiomas occupy an intermediate risk group between benign (WHO grade I) and anaplastic (WHO grade III) meningiomas. Although grade II meningiomas have traditionally been recognized in only about 5% of cases, after changes in diagnostic criteria with the current 2007 WHO standards, they now comprise approximately 20-35% of all meningiomas. Given the magnitude of this change, much work is now needed to solidify the adoption of these standards, to render inter-observer and inter-institutional comparisons more uniform, and to more carefully define the incidence of grade II histology. However, it is clear that they carry a several-fold increased risk of recurrence, as well as an increased rate of mortality. We will discuss the definition, diagnosis, and treatment of patients with atypical meningioma; review the current phase II cooperative trials; and draw attention to some questions timely for pre-clinical and clinical research.
非典型（WHO 分级 II）脑膜瘤位于良性（WHO 分级 I）和间变（WHO 分级 III）脑膜瘤之间，属于中间风险组。尽管传统上认为只有约 5%的病例为 II 级脑膜瘤，但随着当前 2007 年 WHO 标准的诊断标准改变，现在约占所有脑膜瘤的 20-35%。鉴于这种变化的巨大规模，现在需要做大量工作来巩固这些标准的采用，使观察者之间和机构之间的比较更加统一，并更仔细地定义 II 级组织学的发生率。然而，很明显，它们的复发风险增加了数倍，死亡率也增加了。我们将讨论非典型脑膜瘤患者的定义、诊断和治疗；回顾目前的 II 期合作试验；并提请注意一些及时的临床前和临床研究问题。
