不同级别脑膜瘤的临床病理特征和PR、ER、AR的表达差异分析

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摘要目的研究脑膜瘤（IM）的临床病理特征及雌激素受体（ER）、孕激素受体（PR）、雄激素受体（AR）在不同级别IM中的表达差异。方法对2014年5月至2020年11月湖北省中西医结合医院收治的123例IM病例进行回顾性研究。按照IM发生的不同位置、年龄、性别、肿瘤大小、累及周围情况分类，按照世界卫生组织标准重新对肿瘤进行组织学分型和分级。观察复发病例的特征，对增殖标志物Ki67进行定量分析。随机选取部分病例对ER、PR、AR的免疫组化染色进行评估。结果 Ki67增殖指数（PI）与IM分级呈高度正相关（r = 0.808，P ＜ 0.01），肿瘤大小与IM分级呈微弱正相关（r = 0.257，P ＜ 0.01）。Ⅱ级IM的PI高于Ⅰ级活跃，Ⅰ级活跃高于Ⅰ级；Ⅱ级IM的肿瘤大小高于Ⅰ级，差异有统计学意义（P ＜ 0.05）。女性占比79.7%（98例）大于男性20.3%（25例）。PR阳性率为93.0%（53/57），AR阳性率为63.3%（19/30），未检测到ER的阳性信号。不同分级IM的年龄分布、发生部位、累及周围情况、组织学亚型的比较，差异无统计学意义（P ＞ 0.05）。结论 PR可能在IM的发生发展中起重要的作用，某些性激素类药物有可能影响肿瘤的生长，建议实行个体化管理。复发病例的PI、肿瘤级别有提高的倾向。PI、肿瘤大小和组织学形态的结合有助于综合评估IM的生物学行为。

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	高平1 向清明2 杨易1 宗阳如1

关键词 ：脑膜瘤, 增殖指数, 雌激素, 孕激素, 雄激素

Abstract：Objective To study the clinicopathological characteristics of meningiomas (IM) and the expression differences of estrogen receptor (ER), progesterone receptor (PR), and androgen receptor (AR) in different grades of IM. Methods A retrospective study was conducted on 123 cases of IM treated in Hubei Provincial Hospital of Integrated Chinese & Western Medicine from May 2014 to November 2020. According to the different location, age, gender, tumor size, and invasion of IM, the tumor was re-classified and re-graded according to World Health Organization standards. The characteristics of recurrent cases were observed and the proliferation marker Ki67 was quantitatively analyzed. Immunohistochemical staining of ER, PR and AR was evaluated in some randomly selected cases. Results The proliferation index (PI) of Ki67 was highly positively correlated with grades of IM (r = 0.808, P ＜ 0.01), tumor size was slightly positively correlated with grades of IM (r = 0.257, P ＜ 0.01). The PI of grade Ⅱ IM was higher than that of grade Ⅰ with active cell growth, grade Ⅰ with active cell growth was higher than that of grade Ⅰ. The tumor size of grade Ⅱ IM was higher than that of grade Ⅰ, and there were statistically significant (P ＜ 0.05). The percentage of females was 79.7% (98 cases) was significantly higher than that of males 20.3% (25 cases). The positive rate of PR was 93.0% (53/57), the positive rate of AR was 63.3% (19/30), and no positive signal of ER was detected. There were no statistical differences in age distribution, location, invasion and histological types of patients with different grades (P ＞ 0.05). Conclusion PR may play an important role in the occurrence and development of IM. Some sex hormone drugs may affect the growth of the tumor. Individualized management is recommended. Relapsed cases have a tendency to increase tumor grades and PI. The combined analysis of PI, tumor size and histological morphology is helpful to comprehensively evaluate the biological behavior of IM.

Key words： Meningioma Proliferation index Estrogen Progesterone Androgen

基金资助:湖北省卫生健康委联合基金面上项目（WJ2019 H065）。

通讯作者: 向清明（1981.4-），女，博士，主要从事宫颈癌、子宫内膜癌、卵巢癌等病种以放化疗为主的综合治疗工作。

作者简介: 高平（1977.7-），女，硕士，主要从事病理诊断工作。

引用本文:

高平1 向清明2 杨易1 宗阳如1. 不同级别脑膜瘤的临床病理特征和PR、ER、AR的表达差异分析[J]. 中国医药导报, 2021, 18(22): 17-21.
GAO Ping1 XIANG Qingming2 YANG Yi1 ZONG Yangru1. Clinicopathological characteristics and the differences analysis of expression of PR, ER and AR in different grades of meningiomas. 中国医药导报, 2021, 18(22): 17-21.

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https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2021/V18/I22/17

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