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颅内脊索样脑膜瘤的临床特征和治疗:30 例报告。

Clinical features and treatment of intracranial chordoid meningioma: a report of 30 cases.

机构信息

Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China.

出版信息

Histopathology. 2013 Jun;62(7):1002-17. doi: 10.1111/his.12113. Epub 2013 Apr 26.

Abstract

AIMS

To discuss the clinical characteristics and prognosis of chordoid meningioma (CM).

METHODS AND RESULTS

Tumour samples of CM from 30 patients were re-examined. The postoperative outcomes were analyzed on the basis of clinical observations. The survival probabilities were calculated using the Kaplan-Meier method. Thirty-two operations were performed in 30 cases, including 27 operations for total removal and five operations for subtotal removal. The median follow-up period was 34.0 months. Tumour recurred in five patients, with a median recurrence time of 32.0 months. No systemic manifestations of Castleman's syndrome were found. The majority (80%) of tumours were found in the supratentorial compartments. The MIB-1 labelling index (MIB-1 LI) varied from 1% to 10%. In univariate analyses, the presence of aggressive factors (P = 0.001) and the extent of resection (P = 0.037) were related to progression-free survival (PFS). The MIB-1 LI (P = 0.50) and postoperative radiotherapy (P = 0.62) were not related to PFS.

CONCLUSIONS

Chordoid meningioma is a rare subtype of meningioma, and is often found supratentorially. There is an absence of association with Castleman's syndrome. Aggressive factors and the extent of resection are helpful in predicting recurrence. It might be more pertinent to downgrade CM to grade I, unless it shows aggressive factors.

摘要

目的

讨论脊索样脑膜瘤(CM)的临床特征和预后。

方法和结果

对 30 例 CM 肿瘤标本进行了重新检查。根据临床观察分析了术后结果。使用 Kaplan-Meier 方法计算了生存概率。在 30 例病例中进行了 32 次手术,其中 27 次为全切手术,5 次为次全切除手术。中位随访时间为 34.0 个月。5 例患者肿瘤复发,中位复发时间为 32.0 个月。未发现 Castleman 综合征的全身表现。大多数(80%)肿瘤位于幕上腔。MIB-1 标记指数(MIB-1 LI)从 1%到 10%不等。在单因素分析中,侵袭性因素的存在(P = 0.001)和切除程度(P = 0.037)与无进展生存期(PFS)有关。MIB-1 LI(P = 0.50)和术后放疗(P = 0.62)与 PFS 无关。

结论

脊索样脑膜瘤是一种罕见的脑膜瘤亚型,常发生于幕上。与 Castleman 综合征无关。侵袭性因素和切除程度有助于预测复发。除非有侵袭性因素,否则将 CM 降级为 I 级可能更为恰当。

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