尽管临床和组织学特征令人放心，但低级别脑膜瘤在手术后仍可能复发。靶向基因表达谱改善了脑膜瘤的风险分层，但这种方法对临床低风险脑膜瘤的实用性尚不完全清楚。这是一项针对 1992 年至 2023 年在 4 个机构接受治疗的患者脑膜瘤的多中心回顾性队列研究。包括新诊断或复发的世界卫生组织 (WHO) 1 级脑膜瘤，并接受大体全切除 (GTR) 或次全切除 (STR) 治疗，或新诊断的世界卫生组织 (WHO) 2 级脑膜瘤，接受 GTR 治疗。在所有样本中评估了 34 个基因表达生物标志物和基因表达风险评分（从 0 到 1 连续）。研究队列由 723 名患者组成，其中没有一人用于发现或训练基因表达生物标志物，265此前未曾报道过。有 626 例 WHO 1 级脑膜瘤，490 例 GTR，126 例 STR，97 例 WHO 2 级脑膜瘤 GTR。靶向基因表达谱将 51.3% 的临床低风险脑膜瘤分类为分子中风险，9.5% 分类为分子高风险。将基因表达生物标志物与切除范围相结合显示，19.8% 的临床低风险脑膜瘤具有不利的局部无复发 (LFFR) 和总生存 (OS)，其中包括 7.1% 的新诊断患有 GTR 的 WHO 1 级脑膜瘤。风险评分对于 LFFR 具有预后意义（风险评分每增加 0.1，HR 为 1.89，95% CI 1.58-2.25），涵盖所有 WHO 分级、切除范围以及新诊断或复发的表现。靶向基因表达谱可以识别临床低风险手术后可能复发的脑膜瘤。© 作者 2024。由牛津大学出版社代表神经肿瘤学会出版。版权所有。如需商业重复使用，请联系 reprints@oup.com 获取转载和转载的翻译权。所有其他权限都可以通过我们网站文章页面上的权限链接通过我们的 RightsLink 服务获得 - 如需了解更多信息，请联系journals.permissions@oup.com。

Despite reassuring clinical and histological features, low grade meningiomas can recur after surgery. Targeted gene expression profiling improves risk stratification of meningiomas, but the utility of this approach for clinical low-risk meningiomas is incompletely understood.This was a multicenter retrospective cohort study of meningiomas from patients who were treated at 4 institutions from 1992 to 2023. Adult patients with newly diagnosed or recurrent World Health Organization (WHO) grade 1 meningiomas that were treated with gross total resection (GTR) or subtotal resection (STR), or newly diagnosed WHO grade 2 meningiomas that were treated with GTR, were included. A 34-gene expression biomarker and gene expression risk score (continuous from 0 to 1) was evaluated in all samples.The study cohort was comprised of 723 patients, none of which were used for discovery or training of the gene expression biomarker and 265 of which were previously unreported. There were 626 WHO grade 1 meningiomas, 490 with GTR and 126 with STR, and 97 WHO grade 2 meningiomas with GTR. Targeted gene expression profiling classified 51.3% of clinical low-risk meningiomas as molecular intermediate-risk and 9.5% as molecular high-risk. Combining the gene expression biomarker with extent of resection revealed 19.8% of clinical low-risk meningiomas had unfavorable local freedom from recurrence (LFFR) and overall survival (OS), including 7.1% of newly diagnosed WHO grade 1 meningiomas with GTR. The risk score was prognostic for LFFR (HR per 0.1 increase in risk score 1.89, 95% CI 1.58-2.25) across all WHO grades, extents of resection, and newly diagnosed or recurrent presentations.Targeted gene expression profiling can identify clinical low-risk meningiomas that are likely to recur after surgery.© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.