Clinical features of clear cell meningioma: a retrospective study of 36 cases among 10,529 patients in a single institution
Clinical features of clear cell meningioma: a retrospective study of 36 cases among 10,529 patients in a single institution
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DOI：
10.1007/s00701-015-2635-x
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发表时间：
2016-01-01
影响因子：
2.4
通讯作者：
Liu, Pinan
中科院分区：
文献类型：
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作者：
Li, Peng;Yang, Zhijun;Liu, Pinan
透明细胞脑膜瘤（CCM）是一种罕见的脑膜瘤亚型。我们提出了最大的 36 个 CCM 系列，并评估了患者临床结果的几个预后因素。对总共 10,529 名脑膜瘤患者中的 36 名经病理证实的 CCM 患者进行了回顾性分析。CCM 占颅内脑膜瘤的 0.3%，占椎管内脑膜瘤的 1.4%。 CCM 的男女比例（36% vs 64%）与脑膜瘤患者的男女比例（28% vs 72%）相似（卡方检验，p = 0.3）。 CCM 患者诊断时的平均年龄（29.3 +/- 18.4 岁）显着低于脑膜瘤患者的平均诊断年龄（49.8 +/- 11.9 岁）（t 检验，p = 0）。随访期间，15名患者（42%）出现肿瘤复发。复发时间10个月～12年，中位时间29个月。 Kaplan-Meier生存分析显示，全切除后的患者（Simpson I级和II级）的无进展生存（PFS）时间明显长于次全切除后的患者（Simpson III级和IV级）（对数秩检验，p = 0.006）。然而，年龄（千分之一货币符号20岁或> 20岁，p = 0.9）、性别（p = 0.3）、术后放疗（p = 0.4）、孕激素受体染色（阳性或阴性，p = 0.2）和Ki-67指数（千分之一货币符号5 %或> 5 %，p = 0.4）对患者的PFS时间没有显着影响。脊髓脑膜瘤中的 CCM 可能比颅内脑膜瘤中的 CCM 大得多。应尽可能完全切除 CCM，以降低复发风险或延长患者的 PFS 时间。
Clear cell meningioma (CCM) is a rare subtype of meningioma. We present the largest series of 36 CCMs and evaluate several prognostic factors of patient's clinical outcome.Thirty-six patients with pathologically confirmed CCM among a total of 10,529 meningioma patients were retrospectively reviewed.CCM constituted 0.3 % of the intracranial meningiomas and 1.4 % of the intraspinal meningiomas. The male-to-female ratio (36 vs 64 %) for CCMs was similar to that for total meningiomas (28 vs 72 %) patients (chi-squared test, p = 0.3). The mean age at diagnosis of CCM patients (29.3 +/- 18.4 years) was significantly younger than that of total meningiomas (49.8 +/- 11.9 years) patients (t-test, p = 0). During the follow-up, 15 patients (42 %) suffered from tumor recurrence. The recurrence time ranged from 10 months to 12 years, with a median time of 29 months. Kaplan-Meier survival analysis showed that patients after total resection (Simpson grades I and II) had significantly longer progression-free survival (PFS) time than those after subtotal resection (Simpson grades III and IV) (log-rank test, p = 0.006). However, age (a parts per thousand currency sign20 years or > 20 years, p = 0.9), gender (p = 0.3), postoperative radiotherapy (p = 0.4), progesterone receptor staining (positivity or negativity, p = 0.2), and Ki-67 index (a parts per thousand currency sign5 % or > 5 %, p = 0.4) did not have significant effects on patients' PFS time.The proportion of CCM in spinal meningiomas is likely to be much larger than that in intracranial meningiomas. CCMs should be resected totally when possible to decrease the risk of recurrence or prolong patient's PFS time.