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复发性和非复发性脑膜瘤增殖潜能的临床与组织病理学分析

Clinical and histopathological analysis of proliferative potentials of recurrent and non-recurrent meningiomas.

作者信息

Matsuno A, Fujimaki T, Sasaki T, Nagashima T, Ide T, Asai A, Matsuura R, Utsunomiya H, Kirino T

机构信息

Department of Neurosurgery, Teikyo University Ichihara Hospital, Chiba, Japan.

出版信息

Acta Neuropathol. 1996;91(5):504-10. doi: 10.1007/s004010050458.

Abstract

Proliferative potentials of meningiomas from 127 patients were examined immunohistochemically using the anti-Ki-67 monoclonal antibody, MIB-1, on paraffin sections, and the correlation among MIB-1 staining index (SI), histopathological finding, and clinical course of the disease was analyzed retrospectively. The mean MIB-1 SI of 50 male patients with meningioma was 5.5%, whereas that of 77 female patients was 2.7%. Higher MIB-1 SI were observed for younger patients. These age- and sex-related differences in MIB-1 SI were statistically significant. The patients were assigned to one of three groups: those with non-recurrent meningioma (n = 73); those with recurrent meningioma in whom the specimens obtained during the initial surgery were used to calculate the MIB-1 SI (n = 21); and those with recurrent meningioma for whom the specimens obtained during the surgery for recurrent tumors were used to calculate the MIB-1 SI (n = 33). The mean MIB-1 SI in these patients were 1.6%, 3.6%, and 8.8%, respectively, and there were statistically significant differences among these three groups. Statistical analyses reveal that meningiomas with a MIB-1 SI of 3% or more have a significantly high tendency for recurrence during the clinical courses, especially within the first 10-year follow-up periods. Moreover, there is statistically significant correlation between MIB-1 SI and recurrence in each Simpson's grade. The time interval to the next recurrence for recurrent meningiomas is associated with the proliferative potential represented by the MIB-1 SI, and a correlation equation has been proposed to predict the date of the next recurrence. Analyses on cellularity of meningiomas revealed no statistically significant difference in cellularity between non-recurrent and recurrent meningiomas. There was no statistically significant relationship between cellularity and MIB-1 SI of meningiomas. In conclusion, examination on proliferative potentials of meningiomas using MIB-1 SI is very important for biological and histopathological analyses and the prediction of future recurrence.

摘要

采用抗Ki-67单克隆抗体MIB-1,在石蜡切片上对127例患者的脑膜瘤增殖潜能进行免疫组织化学检测,并回顾性分析MIB-1染色指数(SI)、组织病理学表现与疾病临床病程之间的相关性。50例男性脑膜瘤患者的平均MIB-1 SI为5.5%,而77例女性患者的平均MIB-1 SI为2.7%。年轻患者的MIB-1 SI更高。MIB-1 SI在年龄和性别上的这些差异具有统计学意义。患者被分为三组之一:非复发性脑膜瘤患者(n = 73);复发性脑膜瘤患者,其中初次手术获取的标本用于计算MIB-1 SI(n = 21);复发性脑膜瘤患者,其中复发肿瘤手术获取的标本用于计算MIB-1 SI(n = 33)。这些患者的平均MIB-1 SI分别为1.6%、3.6%和8.8%,三组之间存在统计学显著差异。统计分析表明,MIB-1 SI为3%或更高的脑膜瘤在临床病程中,尤其是在最初10年随访期内,复发倾向显著较高。此外,在每个辛普森分级中,MIB-1 SI与复发之间存在统计学显著相关性。复发性脑膜瘤下次复发的时间间隔与MIB-1 SI所代表的增殖潜能相关,并提出了一个相关方程来预测下次复发的日期。对脑膜瘤细胞密度的分析显示,非复发性和复发性脑膜瘤在细胞密度上无统计学显著差异。脑膜瘤的细胞密度与MIB-1 SI之间无统计学显著关系。总之,使用MIB-1 SI检测脑膜瘤的增殖潜能对于生物学和组织病理学分析以及未来复发的预测非常重要。

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