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DOI: 10.1055/s-0040-1702452
Molecular Taxonomy of Meningioma
Publication History
Publication Date:
05 February 2020 (online)
Background: Meningiomas, as the most common primary brain tumor in adults, are undergoing a reawakening in biological understanding. An increasing array of genomic and epigenetic studies has unveiled a cascading array of molecular signatures for meningiomas, with prognostic and phenotypic implications. Among these, aggregates of chromosomal alterations and methylation profiles may portend meningioma recurrence beyond the scope of current histopathologic criteria. However, a rigorous molecular scheme for determination of meningioma behavior, with long-term clinical annotation and outcomes and which is widely accessible to clinicians, is still lacking.
Methods: We analyzed 530 meningiomas from patients who underwent surgical resection between 1999 and 2017 (350 women and 180 men; mean age = 72.5 years) and whose tumors were analyzed by high-resolution array comparative genomic hybridization (aCGH). Clinical data, histopathology, anatomic location, volumetric quantification of preoperative and postoperative MRIs, and radiographic recurrence were evaluated. We devised a molecular classification of meningiomas based on the copy number profile of chromosomes lost or gained and compared the association of progression-free survival with this molecular classification versus standard histopathology.
Results: Meningiomas harbor recurrent chromosomal copy number alterations that significantly associate with classic histopathology but not in all cases. In cases where the molecular classification scheme differed from WHO histopathology grade, the molecular classification augmented prediction of tumor recurrence. We further inferred the chromosomal copy number profile from 150 meningiomas that underwent sequencing for a panel of cancer-associated genes, and demonstrate strong correlation between this profile and that obtained from aCGH, suggesting that copy number analysis may be broadly accessible to clinicians.
Conclusion: We propose a molecular classification for meningioma based on its chromosomal copy number signature, with implication for clinical management and prognostication.
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No conflict of interest has been declared by the author(s).