Clinical Characteristics Of Malignant Meningiomas And Multivariate Analysis Of Postoperative Recurrence

Purpose: To investigate the clinical characteristics of benign meningiomas(BM)and malignant meningiomas(MM),we studied the clinical features and researched the relationships between them and the recurrence of malignant meningiomas.It will be helpful to the diagnosis and treatment of malignant meningiomas.Methods:24 cases of MM treated at the affiliated hospital of Luzhou Medical College,from January 2002 to December 2015 were analysed retrospectively,at the same time 24 cases of benign meningiomas(BM)were analysed as control.We retrospectively analysed the clinical,imaging characteristics of two groups,followed up the patients and compared the differences between them to explore the clinical characteristics of MM.Immunohistochemical method was used to detect the expression of Ki67,EMA,Vimentin and CyclinE in meningioma tissues,and the differences in the expression of benign and malignant meningiomas were analyzed.Combined with the clinical features of malignant meningioma,correlation of the indexes and the recurrence of malignant meningioma were analyzed with Kaplan-Meier single factor analysis,there would be significance to further Cox regression analysis to determining the independent factors affecting the recurrence.Results: No significant difference between benign and malignant meningiomas in the general clinical features(P>0.05);while in the mortality rate,recurrence rate,CT calcification,enhanced MRI inhomogeneous enhancement,peritumoral edema and the Ki-67 LI and the degree of surgical resection significantly(P<0.05).The analysis results on recurrent malignant meningiomas showed age(P = 0.009),peritumoral edema(P=0.005),tumor size(P = 0.050),invasive type(P = 0.011)and extent of surgical resection(P = 0.002)has statistical significance to judge malignant meningioma recurrence.However,by multivariate Cox regression analysis,excluding the invasive type(RR=0.699,95%CI:0.184~2.658,P=0.600),peritumoral edema(RR=2.915,95%CI:0.881~9.648,P=0.080)and tumor size(RR=1.314,95%CI:0.250~6.921,P=0.747),only age(RR=4.379,95%CI:1.125~17.051,P=0.033)and the degree of surgical resection(RR=3.442,95%CI:1.314~9.016,P=0.012)had statistical significance.Conclusion: 1.At present,there were few studies on the recurrence and prognosis of malignant meningiomas.The clinical features and prognosis of malignant meningioma of the survival analysis model,peritumoral edema degree,tumor invasive type and tumor size may affect patients with recurrence.Age and extent of resection were independent factors in determining malignant meningioma recurrence.2.Malignant meningiomas had a unique clinical features,as low incidence,high recurrence rate,high mortality rate,inhomogeneous enhancement of MRI and high peritumoral edema.3.Immunohistochemical expressions of Ki-67 LI was valuable in differential diagnosis of benign and malignant meningiomas.4.Surgical treatment was the first choice for the treatment of malignant meningioma.Adjuvant radiotherapy was necessary for all patients with malignant meningiomas,especially those who are not completely resected.