| 苗 丽,靳耀锋,周 乐,马 莉,陈晓黎.60例颅内外脑膜瘤的临床病理分析[J].,2017,17(21):4112-4115 |
| 60例颅内外脑膜瘤的临床病理分析 |
| Clinicopathological Analysis of 60 Cases of Meningiomas of Intracranial and Extracranial |
| 投稿时间：2016-11-19 修订日期：2016-12-15 |
| DOI：10.13241/j.cnki.pmb.2017.21.028 |
| 中文关键词: 脑膜瘤 病理特征 免疫组化 |
| 英文关键词: Meningioma Pathological features Immunohistochemistry |
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| 中文摘要: |
| 摘要 目的：探讨脑膜瘤的组织发生、病理学特点、分型与临床预后。方法：采用全自动免疫组化Ventana法对60例(包括2例特殊部位)脑膜瘤的组织发生、病理学特点、分型与临床预后的关系进行回顾性分析。结果：60例脑膜瘤中WHOⅠ级有57例，其中皮细胞型19例，纤维型23例，过渡型10例，化生型2例，砂砾体型2例，血管瘤型1例，WHOⅡ级有3例，均为非典型性脑膜瘤。肿瘤发生在大脑凸面者占53.3 %(32/60例)，大脑镰旁16.7 %(10/60例)，小脑桥脑角及其它部位共占30 %(18/60例)。免疫组化检测显示：Vimentin、EMA阳性表达率均为96.7 %(58/60例)，PR阳性表达率69.2 %(42/60例)；S-100阳性表达率47.4 %(28/60例)；CK阳性表达率10 %(6/60例)； GFAP阳性表达率8.3 %(5/60例)；Ki-67阳性表达指数在WHOⅠ级中平均为4.9 %，WHOⅡ级中平均为13.3 %。其中，鼻窦脑膜瘤EMA、Vimentin及S-100均为阳性，PR少数细胞阳性。侧脑室脑膜瘤Vimentin和S-100阳性，EMA和PR灶状阳性。结论：脑膜瘤的组织学分级大部分为WHO I级，少部分为II级（非典型性）和III级（间变型），共15种组织学亚型。颅外与颅内脑膜瘤的组织学形态基本相同。该肿瘤大部分预后良好，但部分术后可复发，且有肿瘤病理分级越高，复发率越高的现象。 |
| 英文摘要: |
| ABSTRACT Objective: To discuss the histogenesis, pathological features, typing and clinical prognosis. Methods: Retrospective analysis to the histogenesis, pathological features, the correlations of typing and clinical prognosis of meningiomas of 60 cases by using automatic immunohistochemistry Venatana Machine (including 2 special body regions). Results: In 60 cases, there were 57 cases of WHOⅠlevel,including 19 cases of meningothelial meningioma, 23 cases of fibrous meningioma, 10 cases of transitional meningioma, 2 cases of metaplastic meningioma, 2 cases of psammomatous meningioma, 1 case of angiomatous. There were 3 cases of WHOⅡlevel that were all atypical meningioma. The tumors origined from the brain convex took up 53.3 %(32/60 cases), those next to the falx cerebri took up 16.7 %(10/60 cases),those origined from both the cerebellopontine angle and other parts of the body totally took up 30 %(18/60 cases). Immunohistochemical detection showed that Vimentin, EMA positive expression rate was 96.7 % (58/60 cases); PR positive ex- pression rate was 69.2 % (42/60 cases); S-100 positive expression rate was 47.4 % (28/60 cases); CK positive expression rate was 10 % (6/60 cases); GFAP positive expression rate was 8.3 % (5/60 cases); Ki-67 positive expression rate in the WHO Ⅰ level was 4.9 % on av- erage, and the WHO Ⅱ level in an average of 13.3 %. The indexes EMA, Vimentin and S-100 expression of the meningioma in the paranasal sinuses were all positive, and a few cells were PR positive. The indexes Vimentin and S-100 expression of the meningioma in the lateral ventricle were positive, while EMA and PR were multifocal positive. Conclusion: Most of the histological classification of meningioma was WHO I level, the small part was II (atypical) and III (inter variant). That was a total of 15 histologic subtypes. The mor- phology of meningiomas of intracranial and extracranial were basically the same. Most of the tumors had a good prognosis, but some pa- tients can relapse after operation. And the higher the tumor pathological level was, the higher the recurrence rate appeared. |
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