摘要
目的旨在观察高级别脑膜瘤的MRI特征和Ki-67增殖指数与肿瘤复发之间的关系。方法对2008年3月至2011年7月在北京三博脑科医院就诊的30例高级别脑膜瘤患者MRI图像及Ki-67进行分析。MRI显示肿瘤内有无囊性成分、是否有硬膜窦、脑动脉主干及视神经等颅内重要结构累及或为颅内外沟通瘤,是否为颅内多发病灶。根据Ki-67增殖指数,将患者分成<10%和≥10%两组。按病灶增强后平均直径,分为1(直径≤30 mm)、2(30 mm<直径≤40 mm)、3(40 mm<直径≤50 mm)、4(直径>50 mm)组。以肿瘤是否复发为因变量,以肿瘤级别、Ki-67增殖指数分组、肿瘤直径分组、有无重要结构受累、肿瘤内有无囊性成分以及是否为多发病灶为自变量,用多元逻辑回归进行分析以确定影响脑膜瘤复发的危险因素。13例有既往手术史及其病理结果的复发性高级别脑膜瘤进行了分析。采用SPSS 13.0统计学软件进行数据处理,其中Ⅱ、Ⅲ级脑膜瘤的Ki-67增殖指数的比较采用t检验,Ⅱ、Ⅲ级脑膜瘤的复发组与尚未复发组之间的肿瘤级别、是否累及重要结构或为沟通瘤、是否为颅底病变、多发病变、囊性病变等项目之间的比较采用Wald法的χ2检验。结果根据2007年WHO脑膜瘤病理分级标准:Ⅱ级(非典型)和Ⅲ级(间变)脑膜瘤分别为13例和17例。其中16例为复发性脑膜瘤,3例Ⅱ级,13例Ⅲ级,14例为未复发性脑膜瘤,10例为Ⅱ级,4例为Ⅲ级。Ⅲ级脑膜瘤的Ki-67增殖指数(12.6%±8.5%)高于Ⅱ级组(5.7%±4.3%)(t=2.695,P=0.013)。复发组的Ki-67增殖指数(12.3%±8.4%)高于非复发组(6.6%±5.7%)(t=2.123,P=0.043)。颅内重要结构受累在复发组(62.5%)及非复发组(21.4%)之间存在统计学差异(χ2=5.129,P=0.024)。逻辑回归分析显示:肿瘤复发风险随着脑膜瘤级别(χ2=5.025,P=0.025),随着颅内重要结构受累(χ2=4.527,P=0.033)及肿瘤体积增大(χ2=4.158,P=0.041)而升高。Ⅲ级脑膜瘤复发的风险是
Objective To observe correlation of magnetic resonance imaging( MRI) features and Ki-67 index in high-grade meningioma with recurrence of tumors. Methods The data of MRI and Ki-67index of 30 patients with high-grade meningiomas of Beijing Sanbo Brain Hospital from Mar. 2008 to Jul. 2011were analyzed. The cystic components in tumor,vital brain structure involved including dural sinus,brain arterial trunk or optic nerve,communication tumor and multiple lesions were detected by MRI. The patients were divided into two groups of < 10% and ≥ 10% of Ki-67. According to the average diameter after enhancement,the lesions were divided into group 1( diameter≤30 mm),group 2( 30 mm < diameter≤40mm),group 3( 40 mm < diameter ≤50 mm),group 4( diameter > 50 mm). The dependent variable was whether the tumor recurrenced,the independent variables was tumor grade,groups of Ki-67 index and tumor size,vital brain structures involved,cystic components and multiple lesions,the logistic regression analysis was performed to determine risk factors of meningioma recurrence. Thirteen patients of recurrent meningiomas with previous history and histologic grade were analysed. All data was processed by SPSS 13. 0 statistical software,Ki-67 proliferation index of gradeⅡ and Ⅲ meningiomas were compared by t-test. Tumor grade,Ki-67 proliferation index,whether involving vital structures or whether it was communication tumor,whether it was skull base lesions,frequently occurring lesions,cystic lesions between recurrence group and no recurrence group of grade Ⅱ and Ⅲ meningiomas was tested and compared by chi-square.Results According to meningioma grading standard constituted by WHO in 2007,there were 13 grade Ⅱ( atypical) and 17 gradeⅢ( anaplastic) meningiomas in the study. There were 16 patients with recurrence meningiomas included 3 gradeⅡand 13 gradeⅢ,and 14 patients with non recurrence meningiomas included10 gradeⅡand 4 gradeⅢ. Ki-67 index of grade 3 meningiomas( 12. 6% ± 8. 5%) was significantly higher than that of
出处
《中华脑科疾病与康复杂志（电子版）》
2012年第4期10-15,共6页
Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）
关键词
脑膜瘤
肿瘤复发
局部
KI-67抗原
磁共振成像
Meningioma
Neoplasm recurrence,local
Ki-67 antigen
Magnetic resonance imaging
