良性脑膜瘤术后复发相关因素分析

Analysis on relevant multi-factors of benign meningioma relapse after surgery

目的探讨影响良性脑膜瘤术后复发的相关因素。方法对2012年5月至2016年5月于河南大学淮河医院接受手术治疗的228例良性脑膜瘤患者临床资料进行分析,根据术后1年内复发情况将其分为复发组(36例)和未复发组(192例)两组。经logistic回归分析影响良性脑膜瘤复发的独立危险因素。结果肿瘤部位、形状、大小、边界、瘤周水肿、手术切除程度(Simpson分级Ⅰ~Ⅲ级)、病理情况是影响良性脑膜瘤术后复发的单因素(P<0.05);肿瘤部位(窦旁镰旁/蝶骨嵴/鞍区)、肿瘤边界不清、手术切除程度(Simpson分级Ⅲ级)、病理情况(上皮型/纤维型)是术后复发的独立危险因素(P<0.05)。结论肿瘤位于窦旁镰旁、蝶骨嵴或鞍区,边界不清,上皮型或纤维型,手术切除程度低的良性脑膜瘤患者术后复发风险更高。临床治疗时尽可能进行SimpsonⅠ级切除,对于未能进行SimpsonⅠ级切除的患者,应关注各影响因素以降低复发风险。

Objective To analyze the relevant multi-factors that influence the benign meningioma relapse after surgery. Methods A total of 228 patients with benign meningioma who underwent surgery and treatment in our hospital during May 2012 and May 2016 were selected as the study objectives. All the patients＇ clinical data were retrospectively analyzed. According to the recurrence within 1 year after operation,the patients were divided into two groups,including the relapse group（36 cases） and the non relapse group（192 cases）. The independent risk factors that influence the relapse of benign meningioma were analyzed by logistic regression. Results The pathological condition,extent of resection（Simpson grade Ⅰ to Ⅲ）,tumor parts,tumor shapes,tumor sizes,tumor boundary and peritumoral edema were single factors that influence benign meningioma relapse after surgery（P〈0. 05）. The pathological condition（epithelial type or fibrous type）,extent of resection（Simpson Ⅲ grade）,tumor parts（beside the sinus falx/sphenoid ridge/sellar region） and unclear boundary of tumor were independent risk factors that influence the benign meningioma relapse after surgery（P〈0. 05）. Conclusions Benign meningioma patients with epithelial type or fibrous type,low extent of resection,near sinuses parts and unclear boundary of tumor have higher risks of relapse after surgery. During the clinical treatment,benign meningioma patients are suggested to be given resection of higher than Simpson I grade. Those patients who have not been given resection of higher than Simpson I grade should be paid attention to the risk factors in order to decrease the relapse risk.