Study On Factors Influencing The Grading Of Peritumoral Brain Edema And Postoperative Recurrence Of Meningioma

Research BackgroundMeningioma is a common intracranial and extracerebral tumor,accounting for about 20%to 30%of all intracranial tumors.The incidence rate in women is about 23 times that in men,and most of them are benign tumors with slow growth.Peritumoral brain edema refers to the increase of water content in the nerve tissue surrounding the central nervous system tumor,which is common in glioma,meningioma and metastatic tumor,and it is very common in neurosurgery.PTBE plays an important role in the diagnosis,treatment and prognosis of tumors.However,the cause and treatment of PTBE is still controversial.Moreover,the cause of PTBE is particular in meningioma,which is extracerebral tumor.Surgical resection is the most important treatment for meningioma.Surgical resection degree and pathological grading are considered to be the most important factors affecting postoperative recurrence of meningioma.However,even benign meningioma still has a certain recurrence rate after gross total resection.Therefore,it is necessary to find out the factors influencing the classification of PTBE and postoperative recurrence of meningioma.1 ObjectiveThis study was performed to determine the clinical,imaging and pathological features of meningioma patients on the impact of the grading of PTBE and postoperative relapse-free survival time,to explore the factors influencing the grading of PTBE and postoperative recurrence of meningioma.It can provide reference for identifying the causes of PTBE and the treatment of meningioma.2 MethodClinical,imaging and pathological data of patients who received surgical treatment in the neurosurgery center of our hospital were collected from September 2012 to February 2019,and the recurrence was followed up.All the cases were confirmed as primary meningioma patients by postoperative pathology.Nonparametric rank-sum test was used to analyze the influence of various factors on the grading of PTBE in meningioma.The correlation between various factors and postoperative recurrence was analyzed by univariate Kaplan-Meier survival analysis and multivariate COX regression analysis.3 ResultsAfter screening by inclusion and exclusion criteria,a total of 124 cases of meningioma were included,aged from 19 to 74.And the ratio of male to female is 1:2.4.Follow-up time ranged from 2months to 86 months,and recurrence was found in 35 cases.There were statistically significant differences between the grading of PTBE and tumor size,enhancement,tumor pathological grading,Ki-67LI and S-100 expression(P<0.05).There was no significant difference between the grading of PTBE and gender,age,tumor resection degree,meningeal tail sign,recurrence and the expression of EMA,PR and GFAP(P>0.05).Univariate Kaplan-Meier survival analysis showed that meningioma patients after gross subtotal resection and Ki-67LI≥7%were found to be more likely to relapsing(P<0.05).After gross total resection,patients with high-grade meningioma had a higher recurrence rate than patients with benign meningioma(P<0.05).The recurrence rate of convex meningioma with PTBE is higher than that without PTBE(P<0.05).Multivariate analysis showed that surgical resection and Ki-67LI were independent risk factors for postoperative recurrence of meningioma(P<0.05).4 ConclusionsThe grading of PTBE in meningioma is influenced by the tumor size,enhancement,pathological grade,Ki-67LI and S-100.The degree of surgical resection and Ki-67LI were independent risk factors for postoperative recurrence of meningioma.Adjuvant therapy is still necessary to reduce the recurrence rate after total resection of high-grade meningioma.Convex meningioma without PTBE has a good prognosis.