影响非典型脑膜瘤术后复发的危险因素分析

摘要

Objective To explore the risk factors for postoperative recurrence of atypical meningioma.Methods The clinical,imaging and pathologic data of 62 patients who underwent surgical treatment and postoperative pathological diagnosis of atypical meningiomas were retrospectively analyzed and the patients were followed up regularly.The risk factors of recurrence were analyzed statistically.Results Sixty-two cases of atypical meningioma patients were followed up for 3 to 128 months and for an average of 45 months.There were 20 cases of recurrence or death.The recurrence rate was 32.26％ (20/62).Univariate analysis showed that not completely resected tumor,maximum diameter of tumor ≥ 5 cm,brain invasion and(or) bone invasion,no assisted radiotherapy and Ki-67 positive index ≥6％ were related to postoperative recurrence of atypical meningioma(P ＜ 0.05).Logistic regression analysis showed that not completely resected tumor,Ki-67 positive index ≥6％,brain invasion and(or) bone invasion,no assisted radiotherapy were related to postoperative recurrence of atypical meningioma (P ＜ 0.05).Conclusions Risk factors for postoperative recurrence in patients with atypical meningioma include not completely resected tumor,Ki-67 positive index ≥6％,brain invasion and (or)bone invasion,and no assisted radiotherapy.For the presence of the above risk factors,close postoperative follow-up is needed.%目的 探讨分析影响非典型脑膜瘤术后复发的危险因素.方法 回顾性分析行手术治疗且术后病理诊断为非典型脑膜瘤的62例患者的临床资料、影像资料及病理学资料,并对患者定期随访,对影响患者术后复发的危险因素进行统计分析.结果 62例非典型脑膜瘤患者随访时间为3 ～ 128个月,平均随访时间为45个月,复发或死于肿瘤复发患者共20例,复发率为32.26％(20/62),单因素分析显示:未全切肿瘤、肿瘤最大直径≥5 cm、脑侵袭和(或)骨侵袭、术后未辅助放疗、Ki-67阳性指数≥6％与非典型脑膜瘤术后复发相关(P＜0.05),Logistic多因素回归分析显示:未全切肿瘤、Ki-67阳性指数≥6％、脑侵袭和(或)骨侵袭、未辅助放疗与非典型脑膜瘤术后复发相关(P＜0.05).结论 影响非典型脑膜瘤患者术后复发的危险因素包括未全切肿瘤、Ki-67阳性指数≥6％、存在脑侵袭和(或)骨侵袭、未辅助放疗,对于存在以上危险因素者,需要密切随访.