Och Waldemar, Szmuda Tomasz, Kulbacki Kamil, Witek Krzysztof, Sikorska Beata, Zakrzewska Magdalena, Springer Janusz, Reszeć Joanna, Parda Agnieszka, Liberski Paweł P
Neurosurgery Department, Regional Specialist Hospital, Olsztyn, Poland.
Neurosurgery Department, Medical University of Gdansk, Gdansk, Poland.
Neurol Neurochir Pol. 2016 Nov-Dec;50(6):395-402. doi: 10.1016/j.pjnns.2016.07.001. Epub 2016 Jul 26.
Meningiomas (MGs) are the frequent benign intracranial tumors. Their complete removal does not always guarantee relapse-free survival. Recurrence-associated chromosomal anomalies in MGs haves been proposed as prognostic factors in addition to the World Health Organisation (WHO) grading, tumor size and resection rate. The aim of this study was to evaluate the frequency of deletions on chromosomes in sporadic MGs and to correlate them with the clinical findings and tumor behaviour. Along with survival, the tumor recurrence was the main endpoint. Chromosomal loss of heterozygosity (LOH) was studied. 46 benign MGs were subjected to the analysis, complete tumor resection was intended and no early mortalities were observed. Incomplete removal was related to parasagittal location and psammomatous hisptopathology (p<0.01). Chromosomal alterations were present in 82.6% of cases; LOH at 22q (67.4%) and 1p (34.8%) were the most frequent and associated with male sex (p=0.04). Molecular findings were not specific for any of the histopathologic grade. Tumor recurrence (14 of 46) correlated with tumor size (≥35mm), LOH at 1p, 14q, coexistence of LOH at 1p/14q, 10q/14q, 'complex karyotype' status (≥2 LOHs excluding 22q), patient age (younger <35), and Simpson grading of resection rate (≥3 of worse prognosis). The last 3 variables were independent significant prognostic factors in multivariate analysis and of the same importance in recurrence prediction (Receiver Operating Characteristic curves comparison p>0.05). Among the cases of recurrence, tumor progression was observed in 3 of 14. In 2 cases, LOH on 1p and/or coexistence of LOH 1p/14q correlated with anaplastic transformation.
脑膜瘤（MGs）是常见的颅内良性肿瘤。其完全切除并不总能保证无复发生存。除了世界卫生组织（WHO）分级、肿瘤大小和切除率外，MGs中与复发相关的染色体异常已被提出作为预后因素。本研究的目的是评估散发性MGs中染色体缺失的频率，并将其与临床发现和肿瘤行为相关联。除生存外，肿瘤复发是主要终点。研究了染色体杂合性缺失（LOH）。对46例良性MGs进行了分析，旨在进行肿瘤完全切除，未观察到早期死亡病例。切除不完全与矢状窦旁位置和砂粒体组织病理学有关（p<0.01）。82.6%的病例存在染色体改变；22q（67.4%）和1p（34.8%）的LOH最为常见，且与男性相关（p=0.04）。分子学发现对任何组织病理学分级均无特异性。肿瘤复发（46例中的14例）与肿瘤大小（≥35mm）、1p、14q的LOH、1p/14q、10q/14q的LOH共存、“复杂核型”状态（≥2个LOH，不包括22q）、患者年龄（<35岁）以及辛普森切除率分级（预后较差的≥3级）相关。在多变量分析中，最后3个变量是独立的显著预后因素，在复发预测中具有同等重要性（受试者工作特征曲线比较p>0.05）。在复发病例中，14例中有3例观察到肿瘤进展。在2例中，1p的LOH和/或1p/14q的LOH共存与间变转化相关。
