Department of Neurosurgery, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.
Institute of Neurosurgery, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.
J Neurooncol. 2023 Jan;161(2):193-202. doi: 10.1007/s11060-022-04034-3. Epub 2022 May 25.
To evaluate the clinicopathological characteristics, radiology, and long-term outcomes of microcystic meningiomas (MM) and compare it with other subtypes of meningiomas managed at a single neurosurgical center.
A total of 87 consecutive patients who underwent surgical resection and were diagnosed as MM between 2005 and 2016 were enrolled for analysis. Clinicopathological, radiology, and prognostic information was collected and analyzed. Progression free survival (PFS) was compared with 659 patients with other subtypes of WHO grade 1 meningiomas and 167 patients with atypical meningiomas treated during the same period.
Fifty six females and 31 males with MM were analyzed. Peri-tumor brain edema was frequent on T2 WI (85%).12 patients (13.8%) experienced tumor progression during the mean follow-up of 101.66 ± 40.92 months. The median PFS was unavailable, and the 5, 10, and 15 year progression-free rates were 96.9%, 84.0%, and 73.9%, respectively. Univariate COX analysis demonstrated skull base location and higher Ki-67 index as significant negative prognostic factors for PFS (P < 0.05); multivariate analysis identified tumor location and Ki-67 index as independent factors (P < 0.01), as well. Of note, the PFS of MM was worse than other WHO grade 1 subtypes (P < 0.001), but better than atypical meningiomas (P < 0.001), and the PFS differences were retained even when the analysis was limited to the patients receiving GTR (P < 0.05).
The PFS of MM was worse than other WHO grade 1 subtypes and better than atypical meningiomas. Skull base location and higher Ki-67 index were independent negative prognostic factors in MM.
评估微囊型脑膜瘤（MM）的临床病理特征、影像学表现和长期预后，并与单一神经外科中心治疗的其他脑膜瘤亚型进行比较。
回顾性分析 2005 年至 2016 年间在我院行手术切除且病理诊断为 MM 的 87 例患者的临床病理、影像学和预后资料。比较 MM 患者的无进展生存期（PFS）与同期接受治疗的 659 例其他 WHO 1 级脑膜瘤亚型和 167 例非典型脑膜瘤患者的 PFS。
共纳入 56 例女性和 31 例男性 MM 患者。T2WI 上瘤周脑水肿常见（85%）。12 例（13.8%）患者在平均 101.66±40.92 个月的随访中出现肿瘤进展。中位 PFS 无法获得，5、10、15 年无进展生存率分别为 96.9%、84.0%和 73.9%。单因素 COX 分析表明颅底位置和较高的 Ki-67 指数是影响 PFS 的显著负性预后因素（P<0.05）；多因素分析显示肿瘤位置和 Ki-67 指数是独立的预后因素（P<0.01）。值得注意的是，MM 的 PFS 比其他 WHO 1 级亚型差（P<0.001），但比非典型脑膜瘤好（P<0.001），即使在接受 GTR 的患者中进行分析时，这种差异仍然存在（P<0.05）。
MM 的 PFS 比其他 WHO 1 级亚型差，比非典型脑膜瘤好。颅底位置和较高的 Ki-67 指数是 MM 的独立负性预后因素。
