The Study About Dural Tail Sign,Pathological Type And The Dural Invision Of Meningiomas

Background: Meningiomas are common central nervous system tumors.Most are benign,with 9-15% of recurrence rate 10 years after surgery.One of the main factors that induce long-term recurrence of patients is meningioma cells invading tumor dura mater.Therefore dura invasion and surgical resection range have been clinically attention hot spot.(DTS)refers to the linear enhancement along the dural mater adjacent the tumor on contrast-enhanced MRI,which is clinically common in meningioma.DTS could be found in 52-72% meningiomas patients thus could be act as the important index for diagnosis and differential diagnosis of meningioma.About DTS,however,remain controversial.The invasion of dura tail sign mater(DTSM),tumor pathological type and resection degree are extensive clinical focused.This study to discuss the clinical significance of meningioma DTS,pathologic type and dura invasion to provide help for clinic.Methods: Total 92 Simpson I and SimpsonⅡlevel resection of menigiomas examples of were selected from the neurosurgery department Xuanwu hospital of capital medical university.According to the preoperative enhancement MRI scans to determine the presence of DTS and its classification;HE staining of the specimens to determine case pathological classification;At least 15 mm of tumor surrounding dura were cut classified to 0 to 1 mm,1 to 5 mm,6-10 mm,and more than 10 mm dura mater and HE staining compared with the primary focal tumors;Immunohistochemical staining of VEGF and PCNA.SPSS11.5 software was adopted for statistical analysis.Results:1.52(56.5%)of 92 cases had DTS,with 18(34.6%)cases long tail type,20(38.5%)cases short tail type and beads tail type 14 cases(26.9%);The average length of DTS was 1.98±1.36 cm.2.Pathological type of 92 meningioma cases was determined by HE staining.84 cases were class I and pathology subtype were endothelial type 28 cases(30.4%),fiber type 34 cases(37.0%),secretory type 12 cases(13.0%)and hemangioma type 10 cases(10.9%)respectively.8 cases(8.7%)were class II,atypia type.3.HE staining of dura specimens with reference to cancer cells of primary tumors to determine whether tumor cells infiltrated.40(43.5%)cases of 92 showed tumor cell infiltrated in the dura mater.The cases of pathologic grade I showed significantly lower invasion rate than grade II(P < 0.05).All 52 cases non-tumor cells infiltrating were of grade I meningioma.4.The dura invasion had no relationship to presence of DTS,but beads tailed type DTS shows higher dura invasion tendency compared with long tail type and short tail type DTS(P < 0.05).There was no significant difference between pathological type and DTS presence.The dura invasion ranged 0-III level have no relationship to DTS.5.PCNA and VEGF expression in dura invaded samples is significantly higher than those non-invaded cases(P < 0.05),but had no relationship to DTSConclusions:1.The rate of DTS was 56.5 %,but DTS has no relationship to the dura matter invasion.2.The dura matter invasion is correlated with primary focal pathological types,but its pathological types had no relationship to DTS.3.The beads-tailed type DTS shows higher dura invasion tendency compared with long tail type and short tail type DTS.4.The dura invasion ranged within 10 mm,and had no relationship to DTS.5.PCNA and VEGF expression correlated with dura invasion,but has no relationship to DTS.