矢状窦旁脑膜瘤病人术后复发情况及影响因素分析

摘要

Objective To analyze the postoperative recurrence and relevant factors of patients with parasagittal meningioma after micro-neurosurgical procedures. Methods Clinical data of 65 patients with parasagittal meningioma were analyzed retrospectively. The patients were followed up for tumor recurrence and the factors influencing the recurrence were analyzed by using multiple Logistic regression. Results All the patients were followed up for 2.6 ± 1.3 years and recurrence occurred in 12 (18.5％). The single factor analysis results showed that the patients with age equal to and more than 60 years, tumor size equal to and more than 4 cm, higher WHO grade, higher Simpson grade, peritumoral edema, nodular meningioma, uniform of enhancement, epidural tail sign and postoperative KPS score less than 70 points had higher recurrence rate of meningioma (P<0.05). Multiple Logistic regression analysis showed that tumor size, WHO grade, Simpson grade, shape of meningioma, epidural tail sign and postoperative KPS score were the independent risk factors for postoperative recurrence in patients with parasagittal meningioma (P<0.05). Conclusions The factors as tumor size, WHO grade, Simpson grade, shape of meningioma, epidural tail sign and postoperative KPS scores may affect the recurrence of patients with parasagittal meningioma after surgery. To reduce recurrence rate of parasagittal meningioma patients after surgery as far as possible, the effective clinical interventions in allusion to the above factors should be adopted.%目的 探讨显微神经外科手术治疗矢状窦旁脑膜瘤病人的复发状况及其影响因素.方法 回顾性分析65例行显微手术的矢状窦旁脑膜瘤病人的临床资料,随访肿瘤复发情况以及通过多因素Logistic回归分析矢状窦旁脑膜瘤复发的影响因素.结果 65例病人平均随访(2.6±1.3)年,复发12例(18.5％).单因素分析发现:年龄≥60岁、肿瘤≥4 cm、WHO分级较高、Simpson切除分级较高、有瘤周水肿、结节形脑膜瘤、强化均一、有硬脑膜尾征以及术后KPS评分<70分的脑膜瘤复发率较高(P<0.05).多因素Logistic回归结果显示:肿瘤的大小、WHO分级、Simpson分级、脑膜瘤形状、有硬脑膜尾征以及术后KPS评分为矢状窦旁脑膜瘤术后复发的独立危险因素(P<0.05).结论 肿瘤大小、WHO分级、Simpson分级、脑膜瘤形状、硬脑膜尾征以及术后KPS评分可影响矢状窦旁脑膜瘤病人术后的复发,临床上应针对上述因素采取有效的干预措施,尽可能降低病人术后复发概率.