雌激素受体表达对间变型脑膜瘤患者预后的影响

The Prognostic Effect of Estrogen Receptor Expression in Anaplastic Meningioma Patients

目的探讨雌激素受体(ER)表达对间变型脑膜瘤患者预后的影响。方法回顾性分析2003至2008年于复旦大学附属华山医院神经外科行手术治疗的70例间变型脑膜瘤患者临床特征及预后。结果除7例患者失访外,余63例患者被纳入预后分析。患者中位无进展生存期(PFS)为(52.0±9.9)个月,3年和5年复发率分别为38.0%和56.1%;中位总生存期(OS)为(70.0±9.7)个月,3年和5年生存率分别为68.3%和54.7%。免疫组化显示,ER表达阳性的患者占50.8%(32/63例);而仅有14.3%(9/63例)患者孕激素受体阳性。生存分析结果显示,术后辅助放疗(PFS,P=0.022)及ER阳性(PFS,P=0.034;OS,P=0.003)为间变型脑膜瘤患者预后的独立影响因素。ER阳性患者的复发率显著高于ER阴性患者(P=0.032)。结论 ER表达水平可作为判断间变型脑膜瘤患者预后的重要影响因素。

Aim To investigate the prognostic effect of estrogen receptor( ER) expression in anaplastic meningioma.Methods Retrospectively collected clinical characteristics and prognosis of 70 anaplastic meningioma cases from 2003-2008 in the neurosurgery department, Huashan Hospital,Shanghai.Results Except seven patients lost follow-up,the remaining 63 patients were included in the final analysis.The median progression-free survival( PFS) was( 52.0 ± 9.9) months,and the 3-year and5-year recurrence rates were 38.0% and 56.1%,respectively;the median overall survival( OS) was( 70.0 ± 9.7) months,and the 3-year and 5-year survival rates were 68.3% and 54.7%,respectively.Immunohistochemistry revealed that ER was weakly positive or positive in 50.8%( 32/63) cases,while progesterone receptor( PR) was only expressed in 14.3%( 9/63) cases.Survival analysis demonstrated that adjuvant radiotherapy( PFS,P = 0.022) and ER expression( PFS,P = 0.034;OS,P = 0.003) were the only independent factor affecting patients ’ survival.Patients with ER positive expression had significantly higher recurrence rate than negative ones( P = 0.032).Conclusion ER expression was a valuable factor to assess the prognosis of anaplastic meningioma patient.