Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
Neurosurg Rev. 2020 Apr;43(2):643-653. doi: 10.1007/s10143-019-01093-5. Epub 2019 Mar 13.
We investigated possible clinical and histopathological prognostic factors in a malignant meningioma cohort with comprehensive long-term population-based follow-up data. Twenty-four consecutive patients treated surgically for malignant meningioma at the Department of Neurosurgery and the Department of Pathology, Rigshospitalet, Copenhagen, Denmark, from December 2000 to March 2014 were retrospectively evaluated regarding progression-free survival (PFS) and overall survival (OS). Clinical parameters were recorded. All specimens underwent immunohistochemical analysis for Ki-67 and phosphohistone-H3 (PHH3). Prognostication was assessed with Cox proportional hazard regression analysis. The median follow-up was 46.1 months (range 0.7-150.7). The median progression-free survival was 16.5 months (95% CI 11.4-43.0) and the median overall survival was 46.6 months (95% CI 20.4-NA). Six patients were alive at the end of follow-up; two of these had not experienced a recurrence. No clinical parameter showed significant association with PFS or OS. Mitotic index (MI) was significantly associated with PFS and OS, and PHH3 MI with PFS. Immunohistochemical reactivity of Ki-67 > 10% was a negative predictor of PFS (HR 3.92, 95% CI 1.47-10.4, p = 0.0063) and OS (HR 3.35, 95% CI 1.12-10.1, p = 0.0313). The histological subgrouping of grade III meningioma into anaplastic and non-anaplastic revealed increased PFS for the latter (HR 4.57, CI 95% 1.32-15.7, p = 0.0164). We could not verify previous clinical parameters as prognostic factors in malignant meningioma. MI and the PHH3 MI were prognostic within WHO grade III meningiomas for PFS. An overall tumor staining of Ki-67 > 10% correlated with PFS and OS within grade III tumors.
我们对一组经综合长期基于人群随访数据的恶性脑膜瘤患者进行了可能的临床和组织病理学预后因素研究。2000 年 12 月至 2014 年 3 月期间，丹麦哥本哈根 Rigshospitalet 神经外科和病理科连续对 24 例接受手术治疗的恶性脑膜瘤患者进行回顾性评估，以评估无进展生存期 (PFS) 和总生存期 (OS)。记录临床参数。所有标本均进行 Ki-67 和磷酸组蛋白-H3 (PHH3) 的免疫组织化学分析。使用 Cox 比例风险回归分析进行预后评估。中位随访时间为 46.1 个月(范围 0.7-150.7)。中位无进展生存期为 16.5 个月(95%CI 11.4-43.0)，中位总生存期为 46.6 个月(95%CI 20.4-NA)。随访结束时，有 6 名患者存活，其中 2 名患者未复发。没有临床参数与 PFS 或 OS 有显著相关性。有丝分裂指数 (MI) 与 PFS 和 OS 显著相关，PHH3-MI 与 PFS 显著相关。Ki-67 免疫组织化学反应性>10%是 PFS(HR 3.92，95%CI 1.47-10.4，p=0.0063)和 OS(HR 3.35，95%CI 1.12-10.1，p=0.0313)的负预测因子。将 3 级脑膜瘤的组织学亚组分为间变性和非间变性，后者的 PFS 增加(HR 4.57，95%CI 1.32-15.7，p=0.0164)。我们无法验证先前的临床参数作为恶性脑膜瘤的预后因素。MI 和 PHH3-MI 是 3 级脑膜瘤 PFS 的预后因素。Ki-67 的总肿瘤染色>10%与 3 级肿瘤的 PFS 和 OS 相关。
