脑膜瘤544例临床病理构成分析

Pathological analysis of 544 cases of meningioma

目的探讨本地区脑膜瘤病理谱和患者的构成,以便临床更好地进行早期诊断和早期治疗。方法收集皖南医学院附属弋矶山医院2011-01～2018-12间诊断明确的脑膜瘤标本。经重新HE染色、免疫组化(Envision二步法)辅助检测,并参照2016版WHO中枢神经系统肿瘤的分类进行组织学诊断和分型。结果 544例脑膜瘤中脑膜上皮型478例(87. 9%)、纤维型22例(4. 0%)、过渡型5例(0. 9%)、砂粒型18例(3. 3%)、血管瘤型8例(1. 5%)、微囊型2例(0. 4%)、化生型1例(0. 2%)、非典型脑膜瘤8例(1. 5%)、恶性脑膜瘤2例(0. 4%)。最常见的组织学类型为脑膜瘤上皮型,其他较常见的类型依次为:纤维型,砂粒型,血管瘤型,过渡型。544例中,男性142例,女性402例,男女比1∶2. 83,女性中位年龄55岁,男性中位年龄58岁,年龄最小14岁,最大83岁,平均年龄(56. 30±11. 07)岁。好发的部位主要为大脑凸面,其次为颅底、矢状窦旁、大脑镰旁。结论本研究为本地区脑膜瘤的流行病学提供了资料,并有助于临床的诊治。

Objective To explore the pathological data and patient ’s characteristics of meningioma in the recent years in the local region for early clinical diagnosis and treatment. Methods Samples of 544 meningioma patients were selected in the Yijishan Hospital of Wannan Medical College from January 2011 to December 2018. The meningioma was diagnosed according to the central nervous system on the WHO classification(2016) by hematoxylin-eosin staining and immunohistochemistry(Envision two-step) method. Results In 544 cases of meningioma, there were 478 cases(87.9%) of meningothelial meningioma,22 cases(4.0%) of fibrous meningioma, 5 cases(0.9%) of transitional meningiom,18 cases(3.3%) of psammomatous meningioma, 8 cases(1.5%) of angiomatous meningioma, 2 cases(0.4%) of microcosmic meningioma, 1 case(0.2%) of metaplastic meningioma, 8 cases(1.5%) of atypical meningioma, and 2 cases(0.4 %) of malignant meningioma. Meningothelial type was the most common histological type, followed by fibrous type, pneumonitis type, angiomatous type and transitional type. Of 544 patients, there were 142 males and 402 females, with a male to female ratio of 1 ∶ 2.83. The median age was 55 years for females and 58 years for males. The patients aged 14-83 years old, and the average age was 56.30 ± 11.071 years. The meningioma often happened in convex parts of the brain, cranial base, parasagittal sinus and parafalcine. Conclusion The present study provides data for the epidemiology of meningioma in the local region and will be helpful for the diagnosis and therapeutic management.