Slower growth of skull base meningiomas compared with non-skull base meningiomas based on volumetric and biological studies
Slower growth of skull base meningiomas compared with non-skull base meningiomas based on volumetric and biological studies
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DOI：
10.3171/2011.11.jns11999
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发表时间：
2012-03-01
影响因子：
4.1
通讯作者：
Yoshimine, Toshiki
中科院分区：
文献类型：
--
作者：
Hashimoto, Naoya;Rabo, Carter S.;Yoshimine, Toshiki
Object.偶然发现的脑膜瘤（IDM）的确切自然史仍然未知。据报道，对于有症状的脑膜瘤，肿瘤位置可以用来预测生长。至于身份证件是否也是如此，还没有报告。本研究的目的是回答这个问题，并提供生物学证据，这一假设通过扩展研究，包括症状的情况下。共113 IDM进行了分析，通过精细容量法。比较了颅底和非颅底IDM之间的生长速率和模式。随后，从作者所在医院同期治疗的210例有症状脑膜瘤患者中获得的材料被纳入使用MIB-1指数对颅底和非颅底肿瘤进行生物学比较。110名IDM患者包括93名女性和17名男性，平均随访期为46.9个月。颅底脑膜瘤38例（34%），非颅底脑膜瘤75例（66%）。42个（37%）没有表现出超过15%的体积增长，而71个（63%）显示增长。38例颅底脑膜瘤中只有15例（39.5%）显示生长，而75例非颅底脑膜瘤中有56例（74.7%）显示生长（p = 0.0004）。在71例IDM（15例颅底和56例非颅底）中，两组在平均年龄、性别、随访期或初始肿瘤体积方面无统计学差异。然而，颅底肿瘤组的生长百分比（p = 0.002）显著低于非颅底肿瘤组，倍增时间（p = 0.008）显著高于非颅底肿瘤组。在随后分析的94例颅底脑膜瘤和116例非颅底脑膜瘤的材料中，颅底肿瘤的平均MIB-1指数（2.09%）明显低于非颅底肿瘤（2.74%; p = 0.013）。颅底IDM倾向于不生长，这与非颅底肿瘤不同。即使当IDM生长时，生长速率也显著低于非颅底肿瘤。基于MIB-1指数分析，在有症状的病例中证实了关于生物学行为的相同结论。作者的发现可能会影响对IDM自然史的理解，以及IDM和症状性脑膜瘤的管理和治疗策略。(DOI：10.3171/2011.11.JNS11999）
Object. The precise natural history of incidentally discovered meningiomas (IDMs) remains unknown. It has been reported that for symptomatic meningiomas, tumor location can be used to predict growth. As to whether the same is true for IDMs has not been reported. This study aims to answer this question and provide biological evidence for this assumption by extending the study to involve symptomatic cases.Methods. A total of 113 IDMs were analyzed by fine volumetry. A comparison of growth rates and patterns between skull base and non-skull base IDMs was made. Subsequently, materials obtained from 210 patients with symptomatic meningiomas who were treated in the authors' hospital during the same period were included for a biological comparison between skull base and non-skull base tumors using the MIB-1 index.Results. The 110 patients with IDMs included 93 females and 17 males, with a mean follow-up period of 46.9 months. There were 38 skull base (34%) and 75 non-skull base (66%) meningiomas. Forty-two (37%) did not exhibit growth of more than 15% of the volume, whereas 71 (63%) showed growth. Only 15 (39.5%) of 38 skull base meningiomas showed growth, whereas 56 (74.7%) of 75 non-skull base meningiomas showed growth (p = 0.0004). In the 71 IDMs (15 skull base and 56 non-skull base), there was no statistical difference between the 2 groups in terms of mean age, sex, follow-up period, or initial tumor volume. However, the percentage of growth (p = 0.002) was significantly lower and the doubling time (p = 0.008) was significantly higher in the skull base than in the non-skull base tumor group. In subsequently analyzed materials from 94 skull base and 116 non-skull base symptomatic meningiomas, the mean MIB-1 index for skull base tumors was markedly low (2.09%), compared with that for non-skull base tumors (2.74%; p = 0.013).Conclusions. Skull base IDMs tend not to grow, which is different from non-skull base tumors. Even when IDMs grow, the rate of growth is significantly lower than that of non-skull base tumors. The same conclusion with regard to biological behavior was confirmed in symptomatic cases based on MIB-1 index analyses. The authors' findings may impact the understanding of the natural history of IDMs, as well as strategies for management and treatment of IDMs and symptomatic meningiomas. (DOI: 10.3171/2011.11.JNS11999)