脑膜瘤细胞多向分化及其临床意义

目的：探讨脑膜瘤多向分化及其与病理诊断和预后的关系。方法：采用光间、电镜、组化染色（网状纤维、PAS－AB和VG）和免疫组化染色S－P法。结果：脑膜瘤共55例，复发7例，复发率为12．73％。脑膜上皮型12例，过渡型13例，纤维型14例，砂粒体型7例，血管瘤型3例，微囊型4例，分泌型2例。Vim、EMA、α1－ACT、FⅧRAg、ER、PR、NSE均不同程度表达，GFAP、desmin及c-erbB-2均阴性。在不同水平上证实上皮样细胞、过渡型细胞及纤维细胞以及玻璃样变性和微囊的病变均有过渡关系。结论：脑膜瘤是一个具有多向分化的肿瘤。各种类型脑膜瘤之间均有移行，其它类型脑膜瘤均是上皮型脑膜瘤分化的结果。脑膜瘤容易复发主要与上皮型脑膜瘤有关。

Multidifferentiation and its clinical significance in meningiomas

Purpose To study the multidifferentiation of meningioma cells and its clinical significances, to try to provide a pathologic basis for clinical diagnosis, treatment and evaluation of prognosis. Methods Fifty five cases of meningioma were studied using usual histologic, immunohistochemical (S P method), electron microscopic techniques and clinical data. Results In 55 cases of meningioma, including 7 recurrent cases,12 cases of epithelial type, 13 of transitional type, 14 of fibrillar type, 7 of grit type, 3 of angioma type, 4 of microcystic type, 2 of secretory type. It was found that epithelial cell, transition cell, fibrillar cell, hyaline degeneration and microcyst had all transitional relationships in vary level. Conclusion Meningioma is one of multidifferentiation tumors. There is transitional phenomenon among types of meningioma. Other types of meningioma are all the results of multidifferentiation from the epithelial type. The recurrent of meningioma may be mainly associated with the epithelial type.