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通过对儿童和成年患者的比较分析,阐述新发生的 NF2 颅内脑膜瘤的临床特征。

Clinical features of newly developed NF2 intracranial meningiomas through comparative analysis of pediatric and adult patients.

机构信息

Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.

Neural Reconstruction Department, Beijing Neurosurgical Institute, Capital Medical University, China.

出版信息

Clin Neurol Neurosurg. 2020 Jul;194:105799. doi: 10.1016/j.clineuro.2020.105799. Epub 2020 Mar 19.

Abstract

OBJECTIVE

NF2 patients can develop new meningiomas throughout their lifetime. Little is known about the clinical features of newly developed NF2 meningiomas. In this study, we analyzed newly developed NF2 meningiomas in a large patient population.

PATIENTS AND METHODS

Among 452 NF2 patients, the location patterns of 81 pediatric and 939 adult NF2 meningiomas were compared to find the predominant locations of newly developed meningiomas in adulthood. The clinical features of 39 newly developed meningiomas in 24 NF2 patients were summarized. Clinical risk factors of NF2 meningioma growth rates were analyzed.

RESULTS

Pediatric patients had significantly more intracranial meningiomas than adult patients at the skull base (except for the petrosal region) (p < 0.0063). Adult patients had significantly more cranial meningiomas than pediatric patients at the parasagittal, parafalcine (middle & posterior), and frontal/parietal/cerebellar convex surfaces (p < 0.0063). Newly developed NF2 meningiomas in adults tended to occur at different locations than the locations of NF2 meningiomas in pediatric patients. New meningiomas could develop at various ages. Ninety-five NF2 patients were imaged and followed up for at least one year. Twenty-four patients (25.3 %) developed 39 new meningiomas during the follow-up period. They usually had initial meningiomas when new meningiomas occurred. The number of newly developed meningiomas per patient and the petrosal location were significantly associated with both the absolute and relative annual growth rates (p < 0.05).

CONCLUSIONS

The number of newly developed NF2 meningiomas seems to be a clinical marker of NF2 disease severity. In adults, new NF2 meningiomas tend to occur in patients with initial meningiomas. The predominant locations of newly developed NF2 meningiomas seem to be the parasagittal, parafalcine (middle/posterior), and frontal/parietal/cerebellar convex surfaces.

摘要

目的

NF2 患者一生中可能会产生新的脑膜瘤。关于新发生的 NF2 脑膜瘤的临床特征知之甚少。在这项研究中,我们分析了大量 NF2 患者中新发生的脑膜瘤。

患者和方法

在 452 名 NF2 患者中,比较了 81 名儿科患者和 939 名成年 NF2 脑膜瘤患者的位置模式,以找到成年后新发生脑膜瘤的主要位置。总结了 24 名 NF2 患者中 39 例新发生的脑膜瘤的临床特征。分析了 NF2 脑膜瘤生长速度的临床危险因素。

结果

与儿科患者相比,成年患者颅骨基底(岩骨区域除外)的颅内脑膜瘤明显更多(p<0.0063)。与儿科患者相比,成年患者矢状旁、蝶骨旁(中后部)和额顶/小脑凸面的颅脑膜瘤明显更多(p<0.0063)。成年患者中新发生的 NF2 脑膜瘤的位置与儿科患者的 NF2 脑膜瘤位置不同。新的脑膜瘤可以在不同的年龄出现。95 名 NF2 患者进行了影像学检查并随访至少一年。在随访期间,24 名患者(25.3%)出现了 39 例新脑膜瘤。当新脑膜瘤发生时,他们通常有初始脑膜瘤。每位患者新发生脑膜瘤的数量和岩骨位置与绝对和相对年增长率均显著相关(p<0.05)。

结论

新发生的 NF2 脑膜瘤的数量似乎是 NF2 疾病严重程度的临床标志物。在成年患者中,新发生的 NF2 脑膜瘤往往发生在有初始脑膜瘤的患者中。新发生的 NF2 脑膜瘤的主要位置似乎是矢状旁、蝶骨旁(中/后部)和额顶/小脑凸面。

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