Bitzer M, Opitz H, Popp J, Morgalla M, Gruber A, Heiss E, Voigt K
Department of Neuroradiology, University of Tübingen, Germany.
Acta Neurochir (Wien). 1998;140(4):333-40. doi: 10.1007/s007010050106.
The correlation between angiographic neovascularization, peritumoural brain oedema (PTBOe) and the expression of vascular endothelial growth factor (VEGF), was analysed in 30 patients with intracranial meningiomas. Pre-operative angiograms were examined for the existence of either an exclusively dural tumour blush or an additionally pial tumour supply from cerebral arteries. Furthermore the presence of macroscopic tumour-neovascularization and dysplastic changes of tumour-draining cerebral veins was evaluated. VEGF expression was investigated on histological tissue samples, using immunohistochemical techniques. VEGF immunohistochemistry and neuroradiological evaluations were performed in double blind fashion. Tumour volume and the amount of oedema were calculated by computerized tomography (CT) or magnetic resonance imaging (MRI). The oedema-tumour volume ratio was defined as oedema index (OeI). Compared to VEGF-negative meningiomas, tumours with striking VEGF staining revealed a significant higher mean oedema index (OeI = 4.2 vs. OeI = 1.5; p < 0.018), and a higher oedema incidence (91.7% vs. 44.4%; p < 0.046). Equally, meningiomas with additionally tumour supply from cerebral arteries were associated with a significant higher mean OeI (OeI = 4.1 vs. OeI = 1.2; p < 0.01) and oedema incidence (94.7% vs. 20.0%; p < 0.0023) than meningiomas with exclusively tumour supply from dural arteries. All meningiomas with striking VEGF-expression were associated with vascular tumour supply from cerebral arteries, but VEGF-negative tumours only in 50% (p < 0.029). These data suggest a link between VEGF-expression, arterial tumour supply and peritumoural brain oedema. The development of tumour supply from cerebral arteries may be important for formation of meningioma-related oedema. Therefore, VEGF may represent a potent mediator in the evolution of this type of vascularization in meningiomas.
对30例颅内脑膜瘤患者分析了血管造影显示的新生血管、瘤周脑水肿（PTBOe）与血管内皮生长因子（VEGF）表达之间的相关性。术前血管造影检查是否存在仅硬脑膜肿瘤染色或额外的来自脑动脉的软脑膜肿瘤供血。此外，评估了宏观肿瘤新生血管的存在以及肿瘤引流脑静脉的发育异常变化。使用免疫组织化学技术在组织学组织样本上研究VEGF表达。VEGF免疫组织化学和神经放射学评估以双盲方式进行。肿瘤体积和水肿量通过计算机断层扫描（CT）或磁共振成像（MRI）计算。水肿-肿瘤体积比定义为水肿指数（OeI）。与VEGF阴性的脑膜瘤相比，VEGF染色明显的肿瘤显示出显著更高的平均水肿指数（OeI = 4.2 vs. OeI = 1.5；p < 0.018）和更高的水肿发生率（91.7% vs. 44.4%；p < 0.046）。同样，有额外脑动脉供血的脑膜瘤与显著更高的平均OeI（OeI = 4.1 vs. OeI = 1.2；p < 0.01）和水肿发生率（94.7% vs. 20.0%；p < 0.0023）相关，而仅有硬脑膜动脉供血的脑膜瘤则不然。所有VEGF表达明显的脑膜瘤都与来自脑动脉的血管肿瘤供血相关，但VEGF阴性肿瘤只有50%如此（p < 0.029）。这些数据表明VEGF表达、动脉肿瘤供血与瘤周脑水肿之间存在联系。脑动脉肿瘤供血的发展可能对脑膜瘤相关水肿的形成很重要。因此，VEGF可能是脑膜瘤这种血管生成演变中的一种有效介质。
