Neurosurgery Department. Hospital Universitario y Politécnico La Fe, Valencia, Spain; Nanomedicine and Sensors Unit, Hospital Universitario y Politécnico La Fe, Universidad Politécnica de Valencia, Spain.
Pathology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
J Clin Neurosci. 2021 Apr;86:32-37. doi: 10.1016/j.jocn.2021.01.009. Epub 2021 Jan 26.
Simpson grading of resection has been used as a predictor of intracranial meningioma (IM) recurrence. Histopathological findings, like the Ki-67/MIB-1 labeling index, may be useful in the assessment risk of recurrence. Our objective was to analyze the predictive value of meningioma recurrence using both parameters. We retrospectively studied 322 consecutive patients with histopathological diagnosis of IM WHO grade I and 43 patients with IM WHO grade II in a 13-year period. Multivariate survival analysis was performed. In the WHO grade I IM group, recurrence was observed in 28 patients (8.69%). The Cox regression model for WHO grade I IM, provided a significative hazard ratio (HR) for Ki-67/MIB-1 index ≥3 (HR = 36.35, p < 0.001) and Simpson's grading resection, grade II (HR = 2.03, p = 0.045), grade III (HR = 3.41, p = 0.034) and grade IV (HR = 19.75, p ≥ 0.001). In the WHO grade II IM group, recurrence was observed in 10 patients (23.25%). The Cox regression model for WHO grade II IM, provided a significative hazard ratio (HR) for Ki-67/MIB-1 index ≥3% (HR = 1.66, p < 0.001) and Simpson's grading resection grade III (HR = 3.96, p = 0.027). The Kaplan-Meier survival curve showed a similar distribution of survival between WHO grade I IM with Ki-67/MIB-1 ≥3% and WHO grade II IM. In WHO grade I meningiomas, the Ki-67/MIB-1 index and Simpson grading were both independent predictors of recurrence. A similar management protocol should be advisable for WHO grade I with Ki-67/MIB-1 ≥3% and WHO grade II meningiomas.
辛普森分级已被用作颅内脑膜瘤 (IM) 复发的预测指标。组织病理学发现，如 Ki-67/MIB-1 标记指数，可能有助于评估复发风险。我们的目的是分析使用这两个参数预测脑膜瘤复发的价值。我们对 13 年间连续收治的 322 例组织学诊断为 I 级脑膜瘤和 43 例 II 级脑膜瘤的患者进行了回顾性研究。进行了多变量生存分析。在 I 级脑膜瘤组中，28 例（8.69%）患者出现复发。I 级脑膜瘤的 Cox 回归模型为 Ki-67/MIB-1 指数≥3（HR=36.35，p<0.001）和辛普森分级切除，II 级（HR=2.03，p=0.045），III 级（HR=3.41，p=0.034）和 IV 级（HR=19.75，p≥0.001）提供了有意义的危险比（HR）。在 II 级脑膜瘤组中，10 例（23.25%）患者出现复发。II 级脑膜瘤的 Cox 回归模型为 Ki-67/MIB-1 指数≥3%（HR=1.66，p<0.001）和辛普森分级切除 III 级（HR=3.96，p=0.027）提供了有意义的危险比（HR）。Kaplan-Meier 生存曲线显示，Ki-67/MIB-1≥3%的 I 级脑膜瘤和 II 级脑膜瘤的生存分布相似。在 I 级脑膜瘤中，Ki-67/MIB-1 指数和辛普森分级都是复发的独立预测因素。对于 Ki-67/MIB-1≥3%的 I 级脑膜瘤和 II 级脑膜瘤，应采用类似的管理方案。
