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Novel histopathological classification of meningiomas based on dural invasion.

基于硬膜浸润的脑膜瘤新的组织病理学分类。

  • 影响因子:2.10
  • DOI:10.1136/jclinpath-2020-206592
  • 作者列表:"Murase M","Tamura R","Kuranari Y","Sato M","Ohara K","Morimoto Y","Yoshida K","Toda M
  • 发表时间:2020-06-16
Abstract

AIMS:Histological invasion into the adjacent brain parenchyma is frequently investigated in meningioma because it is an important morphological criterion for grade II meningioma according to the 2016 WHO classification. However, few studies have focused on dural invasion of meningiomas. Herein, we propose a novel histopathological classification based on dural invasion of meningiomas. METHODS:Forty-nine cases with WHO grade I meningiomas who underwent Simpson grade I removal were collected. After the meningeal layer (ML) and periosteal layer (PL) of dura mater were visualised by Masson's trichrome stain, we evaluated the depth (to the ML and PL) and the patterns (1, expanding; 2, infiltrating) of dural invasion of meningiomas using serial paraffin sections. Invasion-associated markers, including Ki-67, matrix metalloproteinase (MMP)-1, MMP-9 and MMP-13, aquaporin 1 and Na-K-2Cl cotransporter, were quantitatively analysed by immunohistochemistry. RESULTS:Thirty-five cases (71.4%) showed the dural invasion. In 27 of these 35 cases (77.1%), dural invasion was localised in ML. Type 1 (expanding type) and type 2 (infiltrating type) invasions were observed in 23 and 12 cases, respectively. The recurrence rate in cases with type 2 invasion was significantly higher than that in cases with type 1 invasion. The percentage of MMP-1-positive tumour cells was also significantly higher in cases with dural invasion than those without, suggesting involvement of MMP-1 in dural invasion. CONCLUSIONS:We quantitatively evaluated the depth and patterns of dural invasion in meningiomas. The patterns of dural invasion were associated with meningioma recurrence.

摘要

目的: 根据 2016 WHO 分类,脑膜瘤的组织学侵犯邻近脑实质是脑膜瘤的重要形态学标准。然而,很少有研究关注脑膜瘤的硬脑膜侵犯。在此,我们提出了一种新的基于脑膜瘤硬膜侵袭的组织病理学分类。 方法: 收集 49 例接受 Simpson ⅰ 级切除的 WHO ⅰ 级脑膜瘤。通过 Masson 三色染色观察硬脑膜的脑膜层 (ML) 和骨膜层 (PL) 后,我们评估了深度 (到 ML 和 PL) 和使用连续石蜡切片的脑膜瘤硬脑膜侵犯的模式 (1,扩大; 2,浸润)。通过免疫组织化学方法定量分析侵袭相关标志物,包括 Ki-67 、基质金属蛋白酶 (MMP)-1 、 MMP-9 和 MMP-13 、水通道蛋白 1 和 Na-K-2Cl 共转运蛋白。 结果: 35 例 (71.4%) 硬膜受侵。这 35 例中有 27 例 (77.1%) 硬膜侵犯局限于 ML。1 型 (扩大型) 和 2 型 (浸润型) 侵袭分别为 23 和 12 例。2 型浸润病例的复发率明显高于 1 型浸润病例。有硬脑膜浸润的病例 MMP-1-positive 肿瘤细胞比例也显著高于无硬脑膜浸润的病例,提示 MMP-1 参与硬脑膜浸润。 结论: 我们定量评价了脑膜瘤硬膜浸润的深度和模式。硬膜浸润方式与脑膜瘤复发有关。

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影响因子:3.29
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作者列表:["Ang SYL","Lee L","See AAQ","Ang TY","Ang BT","King NKK"]

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