脑膜瘤瘤周血管源性脑水肿与血管内皮生长因子的关系

THE CORRELATION OF VASCULAR ENDOTHELIAL GROWTH FACTOR WITH PERITUMORAL VASOGENIC CEREBRAL EDEMA IN MENINGIOMAS

①目的 探讨脑膜瘤瘤周血管源性脑水肿与血管内皮生长因子的关系。②方法 选择 6 1例幕上非脑室型脑膜瘤病人 ,均进行了脑膜瘤切除术。所有的标本根据MacCarty的病理标准分类。瘤周水肿的存在及程度由磁共振三维扫描确定。血管内皮生长因子的表达用免疫组化检测。③结果 6 1例病人中 ,2 9例无水肿或可疑水肿 ,32例有不同程度的水肿 ,水肿组血管内皮生长因子的阳性表达率显著高于无水肿或可疑水肿组 (χ2 =6 .6 2 ,P <0 .0 1)。脑膜瘤病人血管内皮生长因子阳性表达率为 6 5 .6 %,其中恶性脑膜瘤和脑膜上皮细胞型脑膜瘤阳性表达率分别为 80 .0 %和 75 .0 %,纤维型脑膜瘤阳性表达率为 37.5 %,前两者和后者比较有显著差异 (χ2 =7.5 7,P <0 .0 1;P =0 .0 0 6 )。④结论 血管内皮生长因子可以促进脑膜瘤瘤周血管源性水肿 ,其在脑膜瘤组织中的阳性表达可作为判断脑膜瘤病理分型的指标之一。

Objective\ To evaluate the relationship between vascular endothelial growth factor(VEGF) and peritumoral vasogenic cerebral edema. \ Methods\ Sixty one patients with supratentorial meningioma were selected for resection of the tumor. All the specimens were evaluated pathologically and classified in accordance with Mac Carty criteria. The presence and degree of peritumoral brain edema were confirmed by magnetic resonance imaging. The expression of VEGF was determined immunohistochemically. \ Results\ Of 61 patients studied, 29 exhibited no edema or doubtful and 32 exhibited various degrees of peritumoral edema . The positive expression rate of VEGF in patients with edema was significantly higher than that of no edema or doubtful cases( χ 2=6.62, P <0.01).The expression rate of VEGF in patients with meningioma was 65.6%, in which, malignant meningioma accounted for 80.0%, meningotheliomatous meningioma, 75.0%, and fibroblastic meningioma, 37.5%, respectively. A comparison of the former two and the latter one showed significant difference( χ 2=7.57,P<0.01;P =0.006). \ Conclusion\ VEGF may predispose peritumoral vasogenic cerebral edema in meningioma. The positive expression of VEGF may be used as an indicator for pathological classifications.