欢迎大家讨论，由于文章内容太大，无法上传，有感兴趣的同道留下邮箱给我，将原文发送一起讨论
1.脑膜瘤，非典型脑膜瘤（间变性脑膜瘤），恶性脑膜瘤三者如何移行过度？诊断标准？
2.如何把握处于中间过渡状态的非典型脑膜瘤的诊断标准？
3.脑膜瘤（WHO I）中有多少容易复发？免疫组化有无提示?
4.MCM6蛋白在对临床预后上有无提示作用？
Expression of Minichromosome Maintenance MCM6 Protein in Meningiomas is Strongly
Correlated With Histologic Grade and Clinical Outcome(Am J Surg Pathol 2011;00:000–000)
Abstract: The 2007 World Health Organization histologic
grading of meningiomas is associated with recurrence and
clinical outcome. However, distinction of grade I from grade II
(atypical) meningiomas can be challenging. In the World Health
Organization classification, there are 4 parameters on the basis
of which grade II status can be determined: mitotic rate,
cytoarchitectural features, brain invasion, and/or histologic
subtype. Furthermore, this classification fails to detect grade I
recurrent meningiomas, for which other prognostic criteria
would be needed. The aim of this study was to evaluate the
respective value of several markers involved in cell cycle as
effective tools to predict recurrence. This retrospective study was
based on a series of 59 meningiomas (grade I: 32 of 59, grade II:
27 of 59, all harboring Z4 mitoses/1.6mm2), analyzed with
the following immunohistochemical markers: MCM6, Ki-67,
PHH3, cyclin D1, and p53. We found a significant correlation
between histologic grade and mean labeling index for MCM6
(grade I: 21.8% vs. grade II: 65.8%; P<0.001), Ki-67 (3.2% vs.
16.9%; P<0.001), PHH3 (0.7% vs. 2.8%; P<0.001), cyclin D1
(50.4% vs. 70.0%; P=0.005), and p53 (17.3% vs. 32.4%;
P=0.017). Histologic grading and mitotic index were correlated
with progression-free survival (P=0.010 and P=0.020,
respectively). A nearly linear correlation was found between
progression-free survival and staining for MCM6 (P<0.001),
Ki-67 (P=0.003), and PHH3 (P=0.037) but not for cyclin D1
(P=0.400) and p53 (P=0.758). The interobserver agreement
coefficients for MCM6, Ki-67, PHH3, cyclin D1, and p53 were,
respectively, 0.97 (95% confidence interval, 0.95-0.98), 0.93
(0.89-0.96), 0.81 (0.70-0.88), 0.90 (0.83-0.94), and 0.84 (0.73-
0.90). In conclusion, because of its strong level of expression and
sharp difference in labeling index between indolent and
recurrent tumors, MCM6 is the most efficient marker to identify
tumors with a high risk of recurrence.