脑膜瘤复发的多因素研究(英文)

目的探讨诸多临床因素和影像学特征对脑膜瘤复发的影响。以便能有效地早期预防和控制脑膜瘤复发,改善其预后。方法回顾1993～1997年武汉大学中南医院神经外科经手术治疗脑膜瘤患者145例,对其临床诊治过程和影像学资料进行回顾性分析,发现其中资料齐全的有83例,分析其临床因素如性别、年龄、手术切除程度、组织学类型和影像学特征如瘤周水肿、肿瘤形状、肿瘤大小、骨质改变、肿瘤部位、钙化、瘤周边界、CT 增强形态。应用 SPSS 11.07软件,进行单因素分析和多因素分析。多因素分析应用二值多元 logic 回归模型,以诸多临床因素和影像学特征作为自变量,复发与否作为因变量。结果经单因素分析显示:肿瘤形状、肿瘤大小、瘤周水肿、组织学类型,手术切除程度、肿瘤部位和 CT 增强形态与脑膜瘤复发有明显关系。多因素分析显示:肿瘤形状、肿瘤大小、肿瘤部位、瘤周水肿、组织学类型、手术切除程度、CT 增强形态是影响脑膜瘤复发的主要因素。其它因素在单因素分析及多因素分析中均显示对脑膜瘤复发无明显影响。结论脑膜瘤手术切除程度、组织学类型和 CT 扫描增强对脑膜瘤复发有明显影响。可作为预测脑膜瘤复发的显著危险因子和标准。     

脑膜瘤复发的影像学、临床因素探讨

目的:分析影像学特征和临床因素对脑膜瘤复发的影响。方法:对1992年1月～2000年1月本院神经外科经手术治疗脑膜瘤患者166例进行回顾性分析,应用SPSS11.07通过卡方检验进行单因素分析,应用二值多元Logic回归模型,以影像学和临床指标作为自变量,复发与否作为因变量作多因素分析。结果:单因素分析:肿瘤部位、肿瘤大小、肿瘤形状、瘤周水肿、组织学类型,手术切除程度、CT增强形态与脑膜瘤复发有明显关系,有显著性差异。多因素分析:肿瘤部位、肿瘤形状、手术切除程度、组织学类型、CT增强形态是影响脑膜瘤复发的主要因素,有显著性差异。结论:肿瘤部位、肿瘤形状、手术切除程度、组织学类型和CT扫描增强对脑膜瘤复发有明显影响。     

脑膜瘤复发的临床、影像学因素分析

目的　探讨诸多临床因素和影像学特征对脑膜瘤复发的影响。方法　对 1993～ 1997年武汉大学中南医院神经外科经手术治疗脑膜瘤患者 14 5例进行回顾性分析 ,其中资料齐全的有 83例 ,应用SPSS11.0 7软件通过卡方检验进行单因素分析 ,应用二值多元Logic回归模型 ,以临床和影像学指标作为自变量 ,复发与否作为因变量作多因素分析。结果　单因素分析 :肿瘤形状、肿瘤大小、瘤周水肿、组织学类型 ,手术切除程度、肿瘤部位和CT增强形态与脑膜瘤复发有明显关系 ,有显著性差异。多因素分析 :肿瘤形状、肿瘤部位、组织学类型、手术切除程度、CT增强形态是影响脑膜瘤复发的主要因素 ,有显著性差异。结论　肿瘤形状、肿瘤部位、手术切除程度、组织学类型和CT扫描增强对脑膜瘤复发有明显影响。     

影像学特征与脑膜瘤复发的相关性研究

目的探讨影像学特征对脑膜瘤复发的相关性.以便能有效地早期预防和控制脑膜瘤复发,改善其预后.方法收集1993～1997年武汉大学中南医院神经外科经手术治疗脑膜瘤患者145例,对其影像学资料进行回顾性分析,发现其中资料齐全的有83例,分析影像学特征如瘤周水肿、肿瘤形状、肿瘤大小、骨质改变、肿瘤部位、钙化、瘤周边界、CT增强形态.应用SPSS11.07软件,进行单因素分析和多因素分析.多因素分析应用二值多元logistic回归模型,以影像学特征作为自变量,复发与否作为因变量.结果经单因素分析显示:肿瘤形状、肿瘤大小、瘤周水肿、肿瘤部位和CT增强形态与脑膜瘤复发有明显关系.多因素分析显示:肿瘤形状、肿瘤部位、CT增强形态是影像学因素中影响脑膜瘤复发的主要因素.其它因素在单因素分析及多因素分析中均显示对脑膜瘤复发无明显影响.结论肿瘤形状、肿瘤部位、CT扫描增强对脑膜瘤复发有明显影响.可作为预测脑膜瘤复发的显著危险因子和标准.     

颅内脑膜瘤复发因素的探讨

本文报道颅内脑膜瘤1289例,其中复发性脑膜瘤167例,复发率14.9％.内皮型脑膜瘤复发率高于纤维型和过渡型脑膜瘤,大脑凸面和侧脑室脑膜瘤的复发率最低,矢状窦旁、蝶骨嵴和眶内等部位脑膜瘤的复发率最高.脑膜瘤复发率高低除与肿瘤部位和手术切除级别直接有关外,与肿瘤的病理性质,生长方式以及多灶性生长有关.脑膜瘤有恶变趋势,良性脑膜瘤复发恶变率为25.2％,大脑凸面、矢状窦旁、大脑镰旁、中颅窝和小脑幕等部位脑膜瘤复发恶变率较高.     

16例复发脑膜瘤的临床分析

目的　探讨影响脑膜瘤复发的因素。方法　对 1990年 9月～ 2 0 0 1年 12月收治的 16例复发脑膜瘤的临床资料进行回顾性分析。结果　复发脑膜瘤者男女比例为 3∶1,蕈状、分叶状脑膜瘤 14例 ,7例有囊性变、坏死 ,肿瘤直径 >4cm者 11例。结论　脑膜瘤影像学特征是术前判断有无复发可能的关键     

手术切除脑膜瘤后复发的危险因素分析及手术对策研究

目的分析手术切除脑膜瘤后复发的危险因素,探讨研究适合脑膜瘤患者的手术方式。方法回顾性分析进行手术治疗后复发的160例脑膜瘤患者临床资料,分别对其进行单因素和多因素分析,总结影响手术后再复发的非手术因素和手术因素。结果年龄、术前是否发生癫痫、术前KPS评分与脑膜瘤患者术后的复发无相关性,性别、肿瘤形状、病理类型、肿瘤直径以及是否初发是影响脑膜瘤患者术后复发的重要因素(P<0.05);对脑膜瘤术后患者复发的手术因素分析看出:手术治疗方式(单纯手术、γ刀、手术+放疗、手术+γ刀)与手术切除程度(SimpsonⅠ级、Ⅱ级、Ⅲ级)是影响脑膜瘤患者术后复发的重要的手术因素(P<0.05)。经Logistic回归分析,病理类型、手术治疗方式、肿瘤直径、手术切除程度、是否初发、肿瘤形状以及性别是影响脑膜瘤患者术后复发的重要因素。结论重视影响术后复发的手术因素,对于提高脑膜瘤患者的临床疗效、降低术后复发率具有重要的临床意义。     

WHOⅡ级脑膜瘤术后复发的相关性因素分析

目的:探讨WHOⅡ级脑膜瘤的手术治疗方式及影响患者术后复发的相关因素。方法:以我院2008年1月-2018年6月收治的103名WHOⅡ级的脑膜瘤患者为研究对象,103例WHOⅡ级脑膜瘤患者中9例采用肿瘤次全切（Simpson IV级）,94例采用肿瘤全切术（Simpson I-III级）。103例患者术后复发31例,无复发72例。分析患者年龄、性别、脑膜瘤病理类型、瘤周水肿、肿瘤最大径、肿瘤切除程度及术后放疗等与肿瘤复发的关系。结果:单因素Cox回归分析显示,年龄、性别、肿瘤最大径与肿瘤病理类型对WHO Ⅱ级脑膜瘤术后复发影响较小（P＞0.05）。多因素Cox回归分析显示,伴有瘤周水肿、Simpson分级是影响WHO Ⅱ级脑膜瘤术后复发的独立危险因素（P＜0.05）。术后放疗是WHO Ⅱ级脑膜瘤术后复发的保护因素（P＜0.05）。结论:Simpson分级、有无瘤周水肿及术后是否放疗是影响WHO Ⅱ级脑膜瘤是否复发的相关因素。     

Magnetic Resonance Image Manifestations of the Atypical Meningioma

Through retrospective analysis of 13 cases of magnetic resonance image (MRI) manifestations of atypicalmeningiomas confirmed by operation and pathology in the First Affiliated Hospital of Xinxiang MedicalUniversity, the objective of this study was to evaluate the diagnostic value of MRI in order to improve the accuracyrate of preoperative diagnosis. In this retrospective analysis of MRI findings for atypical meningiomas in FirstAffiliated Hospital of Xinxiang Medical University from January to July in 2012, the location, morphologyand tumor signals and other tumor imaging characteristics were covered. In 13 cases of atypical meningiomapatients of this group, most tumors were located at typical sites (10/13), mainly the falx cerebri, parasagittal,convexity, saddle area. Only two cases were at atypical locations, 1 in the cerebellar hemisphere and 1 in a lateralventricle. Most of the tumors showed T1 and T2 isointensity signals, and necrosis, calcification, and peritumoraledema were always featured. DWI showed isointensity in 11 cases (11/13), and hyperintensity in 2. Some 9 caseshad dural tail signs, 12 had accurate positioning (12/13), and 2 were postoperative recurrences. MRI has highvalue in the diagnosis of atypical meningiomas, with important roles in early clinical diagnosis, treatment andprognosis evaluation.     

Efficacy of Conventional Radiotherapy for Recurrent Meningioma

Results of radiation therapy for 20 patients with recurrent meningioma were analyzed. The patients included 8 men and 12 women, with a median age of 55 years. All of the patients had undergone at least one operation prior to the reoperation preceding radiotherapy. Ten patients had benign meningiomas, while 4 and 6 patients had atypical and malignant meningiomas, respectively, at the time of radiotherapy. The median radiation dose was 59.4Gy (range: 50–61.2Gy). The local control rate at 5 years was 36% for all 20 patients (41% for benign meningiomas and 30% for atypical or malignant meningiomas). The 5-year survival rate was 47%. Excluding 2 patients whose follow-up period was shorter than the preradiotherapy interval from the previous operation, the postradiation recurrence-free period was longer than the preradiotherapy interval in 50% (9/18) of the patients. No serious complications of radiotherapy were observed. Radiotherapy seemed to be effective in controlling the tumor or delaying recurrence in at least half of the patients. However, higher doses of radiation, using sophisticated radiation techniques, may be necessary to obtain higher control rates.     

老年人脑膜瘤27例

 报告老年人脑膜瘤27例，男13例，女14例；年龄60～68岁，平均62.7岁。均经手术治疗，手术死亡率11.1%。并结合老年人脑膜瘤的发病、手术效果等问题进行探讨，为临床诊治老年人脑膜瘤提供了一些经验。     

成人复发性特巨大型脑膜瘤的临床分析(附1例报告)

The authors reported the case of a 35-year-old woman with an unusual huge recurrent meningioma in the left cerebral hemisphere confirmed by the pathological examination.This patient's clinical presentation was very unusual.Brain magnetic resonance imaging(MRI) demonstrated a huge tumor in the left frontal region.The extracranial surface dimensions of the mass were 12cm craniocaudal × 11cm transverse × 9cm anteroposterior;and the intracranial dimensions were 9cm craniocaudal × 7cm transverse × 10cm anteropos...     

Meningioma in the pediatric population

Pediatric meningiomas are rare. They are usually seen in association with neurofibromatosis type 2 (NF-2) or following radiation therapy. The tumors are more frequently intraventricular, cystic, and infratentorial than are those in adult patients. Pathologically they are more histologically aggressive than in adults and tend to recur more frequently. Complete resection is the surgical goal. The treatment of subtotally resected meningiomas, particularly in NF-2, remains controversial.     

Association of Hormonal Contraception with Meningioma Location in Indonesian Patients

Background: Meningioma is the most common primary intracranial tumor. Previous studies have shown the possible association between hormonal contraceptive use and meningioma location. Therefore, this study aimed to analyze the association between the history of hormonal contraceptive use and the location of meningioma in the Indonesian population. Methods: In total, 99 histologically confirmed female meningioma patients admitted to Dr. Sardjito General Hospital Yogyakarta, Indonesia, were included in this study. Data on hormonal contraception and other variables were collected from medical records. Meningioma locations were determined from brain Magnetic Resonance Imaging (MRI) or Computerized Tomography (CT) scan before surgery. Results: Seventy-two (72.7%) patients had a history of hormonal contraceptive use. The subjects consist of 83 (83.8%) WHO grade I and 16 (16.2%) WHO grade II and III tumors. A total of 57 (57.6%) tumors were located in the spheno-orbital region. We found a significant association between hormonal contraceptive use and meningioma location in the spheno-orbital region (Odds ratio (OR) 2.573, p=0.038). This resulted in the patients in the hormonal contraception group having more visual impairment (p=0.044). Conclusion: The use of hormonal contraception is associated with the location of meningioma in the spheno-orbital region.     

进展期胃癌术后早期复发的临床病理因素分析

[目的]探讨进展期胃癌术后复发的时间和影响因素.[方法]回顾性分析155例进展期胃癌术后复发患者的临床病理资料,采用x2检验进行单因素分析,Logistic回归进行多因素分析进展期胃癌患者术后复发的相关因素.[结果] 155例患者平均复发时间为术后12.6个月.其中早期复发(距首次手术≤1年)94例(60.6％),晚期复发(距首次手术＞1年)61例(39.4％).单因素分析显示,胃癌术后早期复发与肿瘤直径、Borrmann分型、分化程度、浸润深度、淋巴结转移、TNM分期有关(P＜0.05).多因素Logistic结果显示,TNM分期和淋巴结转移是进展期胃癌术后早期复发的独立危险因素(P＜0.05).[结论] TNM分期和淋巴结转移是预测进展期胃癌术后早期复发的重要因素.     

Giant Nondural-Based Cauda Equina Meningioma with Multiple Cysts

Summary A very rare case of a giant nondural-based cauda equina meningioma with multiple cysts was presented. Spinal meningioma most commonly occurs in the thoracic or cervical region and typically adheres to the dura. Only six cases of nondural-based meningioma have been reported in English literature. All occurred in the cauda equina region. These patients were predominantly female and younger than those with typical intraspinal meningioma. A 46-year-old woman had a 4-year history of lower back pain and right leg pain. Progressive weakness of both lower extremities occurred. Magnetic resonance imaging revealed a giant cauda equina tumor with multiple cysts from T₁₂ to L₄. Following laminectomies from T₁₁ to L₅ and intradural exposure, the tumor was found to be draped loosely by the roots of the cauda equina and attached to a root without any firm connection with dura mater. Complete removal of the tumor was achieved after microdissection of arachnoid and sacrifice of an involved rootlet of the cauda equina. The appearance of tumor was that of a typical neurilemmoma. However, histological and immunohistochemical analyses were consistent with meningioma. Nondural-based intraspinal meningiomas are very rare, particularly a giant tumor with multiple cysts as our presenting case. All of the cases previously reported, including our case, have been located in the cauda equina region. Most of the patients were female and were young, suggesting that the nondural-based cauda equina meningiomas are age- and sex-related. An accurate preoperative and operative diagnosis are difficult. Care must be taken in the management of cauda equina tumors resembling neurilemmoma which may in fact represent meningioma, particularly in the younger female.