Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
Neural Reconstruction Department, Beijing Neurosurgical Institute, Capital Medical University, China.
Clin Neurol Neurosurg. 2021 Jan;200:106365. doi: 10.1016/j.clineuro.2020.106365. Epub 2020 Nov 11.
Although bilateral vestibular schwannomas (VSs) in individual NF2 patients have the same NF2 gene mutation, they often show different growth patterns. We attempted to identify factors associated with this growth pattern inconsistency.
Cranial MR images of 120 untreated VSs in 60 NF2 patients were carefully reviewed for their growth rates. Growth pattern analysis was performed on 68 VSs in 34 NF2 patients followed up for more than three years with at least three cranial MR scans.
Patient age and tumor volume were significantly associated with NF2 VS absolute growth rates (p < 0.05). Bilateral VS growth patterns in individual NF2 patients were the same in 18 (52.9 %) and different in 16 (47.1 %) patients. Patients with consistent bilateral growth patterns were significantly younger than the inconsistent patients (21.8 ± 5.8 years vs. 30.8 ± 13.1 years, p = 0.014). The bilateral VS volume consistency rates were significantly higher in patients with consistent growth patterns than in patients with inconsistent growth patterns (10/18 vs. 3/16, p = 0.028).
Patient age and volume consistency are the clinical risk factors for bilateral NF2 VS growth pattern inconsistencies. Bilateral VSs in young NF2 patients tend to have the same growth patterns. These findings may help us to predict the future clinical behavior of small NF2 VSs based on the past clinical history of the large ones.
尽管单个 NF2 患者的双侧听神经鞘瘤（VS）具有相同的 NF2 基因突变，但它们通常表现出不同的生长模式。我们试图确定与这种生长模式不一致相关的因素。
对 60 例 NF2 患者的 120 例未经治疗的 VS 的颅磁共振成像（MRI）进行仔细复查，以评估其生长率。对 34 例 NF2 患者的 68 例 VS 进行生长模式分析，这些患者的随访时间超过三年，至少进行了三次颅 MRI 扫描。
患者年龄和肿瘤体积与 NF2 VS 的绝对生长率显著相关（p<0.05）。在 18 例（52.9%）和 16 例（47.1%）患者中，双侧 VS 的生长模式相同和不同。双侧生长模式一致的患者明显比不一致的患者年轻（21.8±5.8 岁 vs. 30.8±13.1 岁，p=0.014）。双侧 VS 体积一致性率在生长模式一致的患者中明显高于生长模式不一致的患者（10/18 对 3/16，p=0.028）。
患者年龄和体积一致性是双侧 NF2 VS 生长模式不一致的临床危险因素。年轻 NF2 患者的双侧 VS 倾向于具有相同的生长模式。这些发现可能有助于根据大 VS 的既往临床病史预测小 NF2 VS 的未来临床行为。
