脑膜瘤复发的多因素研究

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增强形态是影响恼膜瘤复发的主要因素。其它囟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。

Multivariate Analysis of Recurrence in Meningioma

Objective: To evaluate the clinical andradiological factors that affect the recurrence of the meningiomapatient so as to effectively prevent and cure recurrence ofmeningioma patients more earlier. Methods: Theclinical features and radiological aspects in 145 cases ofmeningiomas undergoing operation during 1993--1997 wereretrospectively studied. The data of only 83 cases of all 145cases were available. The factors were evaluated with univariateand multivariate analysis. Results: Withunivariate analysis, 7 factors showed highly significance torecurrence of meningiomas: tumor size, tumor location, tumorshape, edema, extent of resection, pathological grade, CTenhancement. With multivariate analysis, 4 factors showedsignificant danger to recurrence of meningiomas: pathologicalgrade, extent of resection, tumor shape and CT enhancement.Conclusion: The main factors that affect therecurrence of meningioma patients are pathological grade, extentof resection, tumor shape and CT enhancement.