Chen W Y, Liu H C
Department of Pathology, National Yang Ming Medical College, Taipei, Taiwan, Republic of China.
Clin Neuropathol. 1990 Mar-Apr;9(2):74-81.
Two-hundred-and-eighty meningiomas of the surgical pathological files of the Taipei Veterans General Hospital from the period 1976-1986 were reviewed by the authors without prior knowledge of clinical circumstances or outcome. Thirty-four cases were regarded as atypical or anaplastic based on high cellularity, pleomorphism and the presence of mitotic figures with 6 cases showing only the above features and the remaining 28 displaying in addition one or more of the following "ominous" variables: papillary formation, necrosis and invasion of the underlying brain. With a median follow-up of three years after surgery the recurrence rate was 44% (15 cases) for this group of tumors whereas the remaining 246 histologically benign meningiomas had a 6% recurrence rate during the same period. This difference was statistically significant (p less than 0.0001). Once the atypical or anaplastic character of a meningioma was established, no difference in the recurrence rate was found related to the number of mitoses and whether the additional ominous variables were present, alone or in conjunction with others. Immunostaining for vimentin, S100, fibronectin and EMA showed variable results in the 34 atypical meningiomas but without significant difference between those that recurred within 3 years and the ones that did not.
作者回顾了台北荣民总医院1976 - 1986年手术病理档案中的280例脑膜瘤，事先对临床情况或结果不知情。根据细胞密度高、多形性以及有丝分裂象的存在，34例被视为非典型或间变性脑膜瘤，其中6例仅表现出上述特征，其余28例还表现出以下一种或多种“不祥”变量：乳头状形成、坏死和侵犯下方脑实质。这组肿瘤术后中位随访三年，复发率为44%（15例），而同期其余246例组织学上为良性的脑膜瘤复发率为6%。这种差异具有统计学意义（p小于0.0001）。一旦确定脑膜瘤具有非典型或间变性特征，复发率与有丝分裂数量以及是否存在额外的不祥变量（单独或与其他变量一起）无关。对波形蛋白、S100、纤连蛋白和上皮膜抗原进行免疫染色，在34例非典型脑膜瘤中结果各异，但在3年内复发的脑膜瘤和未复发的脑膜瘤之间无显著差异。
