脑膜瘤VEGFR-2表达水平与疾病复发及预后的关系

VEGFR-2 expression level and its relationship between disease recurrence and prognosis in meningiomas

目的:探讨脑膜瘤血管内皮细胞生长因子受体-2(VEGFR-2)表达水平与疾病复发和预后的关系。方法:选取本院2016年8月至2018年8月收治的143例脑膜瘤患者为脑膜瘤组,另取同期收治的因脑外伤切除脑组织的69例患者为对照组。比较两组组织VEGFR-2表达情况。随访3年,根据预后将脑膜瘤患者分成预后良好组、预后不良组,利用多元Cox回归分析脑膜瘤预后的危险因素。通过Kaplan-Meier生存曲线与Log-rank χ^(2)检验分析VEGFR-2表达与患者复发率、累积生存率的关系。结果:脑膜瘤组VEGFR-2阳性率为78.32%,高于对照组的14.49%(P<0.05)。预后不良组年龄≥50岁、肿瘤最大径≥5 cm、包绕血管神经、海绵窦受累、视神经管受累、VEGFR-2阳性、WHOⅢ级占比高于预后良好组,手术全切、术后辅助治疗占比低于预后良好组(P<0.05)。多因素Cox回归分析提示,肿瘤最大径≥5 cm、包绕血管神经、海绵窦受累、VEGFR-2阳性、WHOⅢ级是脑膜瘤预后不良危险因素,手术全切、术后辅助治疗是预后保护因素(P<0.05)。VEGFR-2阳性组复发率高于VEGFR-2阴性组(P<0.05)。结论:脑膜瘤VEGFR-2表达增高,且阳性表达者3年疾病复发率更高,但对累积生存率未见明显影响。

Objective:To investigate the relationship between the expression of vascular endothelial growth factor receptor-2(VEGFR-2)and disease recurrence and prognosis in meningiomas.Methods:143 patients with meningioma treated in our hospital from August 2016 to August 2018 were selected as meningioma group,and 69 patients with brain tissue removed due to brain trauma in the same period were selected as control group.The expression of VEGFR-2 in the two groups was compared and followed up for 3 years.According to the prognosis,they were divided into good prognosis group and poor prognosis group,multivariate Cox regression model was used to analyze the prognostic risk factors of meningiomas.Kaplan-Meier survival curve and Log-rank χ^(2) test were used to analyze the relationship between VEGFR-2 expression and recurrence rate,and cumulative survival rate was analyzed.Results:The positive rate of VEGFR-2 in the meningioma group was 78.32%,which was higher than 14.49%in the control group(P<0.05).The poor prognosis group had more cases with age≥50 years old,the maximum tumor diameter≥5 cm,vascular nerve,cavernous sinus involvement,optic canal involvement,VEGFR-2 positive and WHO gradeⅢthan those in the good prognosis group,and had lower proportions of total resection and postoperative adjuvant therapy than those in the good prognosis group(P<0.05).Multiple Cox regression model analysis showed that the maximum tumor diameter≥5 cm,surrounding blood vessels and nerves,involvement of cavernous sinus,positive VEGFR-2 and WHO gradeⅢwere the risk factors for poor prognosis of meningiomas,and total resection and postoperative adjuvant treatment were the protective factors for prognosis(P<0.05).The recurrence rate of VEGFR-2 positive group was higher than that of VEGFR-2 negative group(P<0.05).Conclusion:The positive expression of VEGFR-2 is increased in meningiomas,and the 3-year disease recurrence rate was higher in those with positive expression,however,it has no significant effect on the cumulative survival rate.