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目的探讨脊索瘤型脑膜瘤的临床、病理特征及预后特点。方法回顾性分析22例行手术切除并经病理证实为脊索瘤型脑膜瘤患者的临床资料,应用相应抗体重新染色标记并进行临床疗效随访。结果 22例患者中,男性9例、女性13例;平均年龄46.5岁。均未见明确有Castleman综合征表现;病变均系单发,多数位于小脑幕上。病理检查示脊索样基质占20%~80%,淋巴细胞浸润以B细胞为主,细胞增殖标记物(MIB-1)标记指数为2%~10%,平均2.5%。19例患者达全切,3例患者达次全切除。所有患者均获随访,平均随访时间44.0个月,4例患者复发;次全切除与复发相关;复发患者MIB-1标记指数与非复发患者比较差异无统计学意义。结论脊索瘤型脑膜瘤是非典型脑膜瘤的一个少见亚型,具有复发风险,女性略多见;患者缺乏明确的系统性疾病表现,小脑幕上是好发部位,手术切除程度与患者预后相关,MIB-1标记指数预测复发的意义尚难肯定。
Objective To investigate the clinical, pathological and prognostic features of chordoma meningioma. Methods Retrospective analysis of 22 cases of patients with surgical excision and pathologically confirmed chordoma meningioma clinical data, the corresponding antibody re-staining and clinical follow-up. Results Of the 22 patients, 9 were males and 13 were females; mean age was 46.5 years. Castleman syndrome were found no clear performance; lesions were single, most located in the tentorium. Pathological examination showed that the spinal cord-like matrix accounted for 20% to 80%, lymphocyte infiltration of B cells, cell proliferation marker (MIB-1) labeling index of 2% to 10%, an average of 2.5%. Nineteen patients underwent total resection and three patients underwent total resection. All patients were followed up with an average follow-up time of 44.0 months. Four patients relapsed. Subtotal resection was associated with recurrence. There was no significant difference between MIB-1 index and non-recurrence patients. Conclusions Chordoma meningioma is a rare subtypes of atypical meningioma with recurrence risk. Female patients are more common. Patients have no definite systemic disease manifestations. The supratentorial tentorium is a predilection site. The degree of resection is related to the prognosis of patients. The significance of MIB-1 marker index in predicting relapse is hard to confirm.