CLASSIC, ATYPICAL, AND ANAPLASTIC MENINGIOMA - 3 HISTOPATHOLOGICAL SUBTYPES OF CLINICAL RELEVANCE
CLASSIC, ATYPICAL, AND ANAPLASTIC MENINGIOMA - 3 HISTOPATHOLOGICAL SUBTYPES OF CLINICAL RELEVANCE
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DOI：
10.3171/jns.1992.77.4.0616
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发表时间：
1992-10-01
影响因子：
4.1
通讯作者：
BUDKA, H
中科院分区：
文献类型：
--
作者：
MAIER, H;OFNER, D;BUDKA, H
本研究将脑膜瘤的组织病理学分类与其生物学活性的临床病理特征相关联。对1582例1799例脑膜瘤手术标本进行了回顾性分析。典型脑膜瘤、以细胞增多为特征的不典型脑膜瘤、间变性(恶性)脑膜瘤和血管外皮细胞或乳头状脑膜瘤分别占87.6%、7.2%、2.4%和2.8%。经手术治疗的经典型脑膜瘤、不典型脑膜瘤、间变性脑膜瘤和血管外皮细胞或乳头状脑膜瘤的复发率分别为6.96%、34.6%、72.7%和68.2%。对252例各种组织病理学类型的肿瘤的手术范围、肿瘤大小和部位进行了详细研究。典型脑膜瘤在完全切除后复发较多，而不典型和间变性肿瘤在完全切除后复发更为频繁。典型脑膜瘤、血管外皮细胞瘤和乳头状脑膜瘤在手术中比不典型脑膜瘤和恶性脑膜瘤小。与经典脑膜瘤相比，非典型脑膜瘤和侧凸区脑膜瘤的手术次数更多。为了支持作者通过与增殖相关的定量参数对脑膜瘤的主观分类，对112例脑膜瘤进行了嗜银核仁组成区蛋白(Ag-NOR)染色。Ag-NOR计数在经典型肿瘤、不典型肿瘤和间变性肿瘤之间有显著差异，但在原发肿瘤和复发肿瘤之间无显著差异。血管外皮细胞瘤和乳头状脑膜瘤的Ag-NOR值低于间变性脑膜瘤。Ag-NOR数与作者的恶性组织病理学分级的相关性支持引入具有中等生物学行为的非典型脑膜瘤。经典和间变性脑膜瘤。在所有恶性肿瘤中，Ag-NOR计数的重叠可能限制了个别病例的Ag-NOR计数的预后价值。
This study correlates the histopathological classification of meningiomas with clinicopathological features of biological activity. A retrospective evaluation of 1799 surgical specimens of meningiomas from 1582 patients was made. The classic histopathological type, atypical meningiomas defined by increased cellularity and at least five mitotic figures in 10 high-power fields, anaplastic (malignant) meningiomas, and hemangiopericytic or papillary meningiomas were seen in 87.6%, 7.2%, 2.4%, and 2.8% of Operations, respectively. The rates of recurrence in surgically treated patients with classic, atypical, anaplastic, and hemangiopericytic or papillary meningiomas were 6.96%, 34.6%, 72.7%, and 68.2%, respectively. The extent of surgery and the tumor size and site were studied in detail in 252 tumors of all histopathological types. Recurrences were ram in classic meningiomas after complete resection, whereas atypical and anaplastic tumors recurred after complete resection much more frequently. Classic meningiomas, hemangiopericytomas, and papillary meningiomas were smaller at surgery than atypical and malignant meningiomas. Atypical and malignant tumors were operated on more often in falcine and lateral convexity regions than were classic meningiomas.To support the authors' subjective categorization by a quantitative parameter related to proliferation, 112 meningiomas comprising all histopathologicat subtypes were investigated for staining of argyrophilic nucleolar organizer region proteins (Ag-NOR's). The Ag-NOR counts showed significant differences between classic, atypical, and anaplastic tumors but no significant differences between primary and recurrent tumors. Hemangiopericytomas and papillary meningiomas had lower Ag-NOR values than anaplastic meningiomas.A correlation of Ag-NOR numbers with the authors' histopathological scale of malignancy supports the introduction of atypical meningiomas with intermediate biological behavior on the classification scale classic and anaplastic meningiomas. Overlapping of Ag-NOR numbers among all groups of malignancy may restrict the prognostic value of Ag-NOR counting in the individual case.