良性脑膜瘤术后复发的危险因素探讨

Risk Factors for Postoperative Recurrence of Benign Meningiomas

目的探讨良性脑膜瘤术后复发的危险因素。方法选取承德医学院附属医院收治的241例良性脑膜瘤术后患者作为研究对象(采用回顾性分析),选取时间为2018年1月~2021年3月,并对所有患者临床基本资料进行整理、分析,按照其术后1年内是否复发分为未复发组(212例)和复发组(29例)。单因素分析两组患者的临床资料,多因素Logistic回归分析其中有统计学意义的因素,并筛选出影响良性脑膜瘤术后复发的独立危险因素。结果良性脑膜瘤术后患者中,复发组肿瘤部位(大脑镰或静脉窦)、肿瘤最大直径>5cm、肿瘤部分切除、肿瘤边界不清、组织病理内皮型/成纤维型以及Ki-67表达≥8%的患者比例均高于未复发组,差异有统计学意义(P<0.05);而两组患者性别、年龄、肿瘤形状、瘤周水肿、脑膜尾征、脂肪酸合成酶(FASN)表达、增殖细胞核抗原(PCNA)表达经比较,差异无统计意义(P>0.05);肿瘤部位(大脑镰或静脉窦)、肿瘤最大直径>5cm、肿瘤部分切除、肿瘤边界不清、组织病理内皮型/成纤维型以及Ki-67表达≥8%均为影响良性脑膜瘤术后患者复发的危险因素,差异有统计学意义(P<0.05)。结论肿瘤部位(大脑镰或静脉窦)、肿瘤最大直径>5cm、肿瘤部分切除、肿瘤边界不清、组织病理内皮型/成纤维型以及Ki-67表达≥8%均为影响良性脑膜瘤术后患者复发的危险因素。因此,临床可采取相应措施进行防治良性脑膜瘤术后患者,以改善其预后,降低复发率。

Objective To explore the risk factors of postoperative recurrence of benign meningioma.Methods A total of 241 cases of postoperative patients with benign meningiomas in Affiliated Hospital of Chengde Medical University were selected as the research object(using a retrospective method),the selection time is from January 2018 to March 2021,and all the patients’clinical basic data were sorted and analyzed.According to whether the recurrence within 1 year after surgery,patients were divided into no recurrence group(212 cases)and recurrence group(29 cases).Single factor analysis was applied to analyze the clinical data of the two groups,and multivariate Logistic regression analysis was applied to analyze the statistically significant factors and screen out the independent risk factors for postoperative recurrence of benign meningioma.Results Among the postoperative patients with benign meningiomas,the proportion of patients with tumor site(cerebral falx or venous sinus),maximum tumor diameter>5cm,partial tumor resection,unclear tumor boundary,histopathological endothelial type/fibroblast and Ki-67 expression≥8% in the recurrence group was higher than that in the non-recurrence group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in gender,age,tumor shape,peritumoral edema,meningeal tail sign,FASN expression and PCNA expression between the two groups(P>0.05).Tumor location(cerebral falx or venous sinus),tumor maximum diameter>5cm,partial tumor resection,unclear tumor boundary,histopathological endothelial type/fibroblast and Ki-67 expression≥8% were all risk factors for recurrence of benign meningioma postoperative patients.The differences were statistically significant(P<0.05).Conclusion Tumor site(cerebral falx or venous sinus),maximum tumor diameter>5cm,partial tumor resection,unclear tumor boundary,histopathological endothelial type/fibroblast and Ki-67 expression≥8% are all risk factors for recurrence of patients with benign meningioma after operation.Therefore,corresponding clinical measures can be taken to prevent and treat patients with benign meningioma after operation to improve their prognosis and reduce recurrence rate.