Subscribe to RSS
DOI: 10.4103/JLP.JLP_158_16
Spectrum of meningioma with special reference to prognostic utility of ER,PR and Ki67 expression
Financial support and sponsorship: NilAbstract
BACKGROUND: Meningiomas are the most common primary central nervous system neoplasms originating from the arachnoid cap cells and constitute between 13% and 26% of all intracranial tumors.
AIMS AND OBJECTIVES: The aim of the study was to analyze the age-, sex-, and site-wise distribution of different histological patterns of meningiomas seen in our center and to assess the status of estrogen receptor (ER), progesterone receptor (PR), and proliferation marker Ki-67 in various grades of meningioma.
MATERIALS AND METHODS: A prospective study was done in 90 cases. Patients presented with symptoms of headache and seizure and underwent subsequent excision surgery at Neurosurgery Department were taken. We have studied histological typing and grading of the tumors, and immunohistochemical staining was done for ER, PR, and Ki-67.
STATISTICAL ANALYSIS: Two-group comparison was done using Mann–Whitney U-test and Fisher’s exact test. Comparison of Ki-67 expression between Grade 1 and Grade 2 meningiomas was determined using Mann–Whitney U-test. Comparison of ER and PR status between different histological grades was done by Fisher’s exact test. Two-tailed P < 0.001 was considered statistically significant.
RESULTS: According to histological type, meningothelial meningioma is most common (38.8%) followed by transitional (22.2%). PR positivity is seen in 96.34% of Grade 1 tumors, and all Grade 2 tumors were PR negative (Fisher’s exact test P < 0.001). About 3.66% of Grade 1 and all Grade 2 tumors were positive for ER (Fisher’s exact test two-tailed P < 0.001). Mean Ki-67 labeling index (LI) was 2.57 ± 1.674 among Grade I tumors, 7.11 ± 1.084 in Grade II meningiomas.
CONCLUSIONS: Most of Grade 1 meningiomas show PRs positivity and lack of ERs positivity. Meningiomas with higher proliferation index and negative PR are very likely to be Grade II or Grade III. Evaluation of ER, PR status, and Ki-67 labeling index (LI) with histological evaluation helps us in providing information about the biologic behavior of meningiomas.
Publication History
Received: 24 December 2016
Accepted: 22 June 2017
Article published online:
19 February 2020
© 2017.
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
References
- 1 Marosi C, Hassler M, Roessler K, Reni M, Sant M, Mazza E, et al. Meningioma. Crit Rev Oncol Hematol 2008;67:153-71.
- 2 Black PM. Meningiomas. Neurosurgery 1993;32:643-57.
- 3 Willis J, Smith C, Ironside JW, Erridge S, Whittle IR, Everington D. The accuracy of meningioma grading: A 10-year retrospective audit. Neuropathol Appl Neurobiol 2005;31:141-9.
- 4 Cordera S, Bottacchi E, D'Alessandro G, Machado D, De Gonda F, Corso G. Epidemiology of primary intracranial tumours in NW Italy, a population based study: Stable incidence in the last two decades. J Neurol 2002;249:281-4.
- 5 Klaeboe L, Lonn S, Scheie D, Auvinen A, Christensen HC, Feychting M, et al. Incidence of intracranial meningiomas in Denmark, Finland, Norway and Sweden, 1968-1997. Int J Cancer 2005;117:996-1001.
- 6 Jääskeläinen J, Haltia M, Servo A. Atypical and anaplastic meningiomas: Radiology, surgery, radiotherapy, and outcome. Surg Neurol 1986;25:233-42.
- 7 Louis DN, Budka H, von Deimling A. Meningiomas. In: Kleihues P, Cavenee WK, editors. Pathology and Genetics of Tumours of the Nervous System. Lyon: IARC Press; 2000. p. 134-41.
- 8 Roser F, Nakamura M, Bellinzona M, Rosahl SK, Ostertag H, Samii M. The prognostic value of progesterone receptor status in meningiomas. J Clin Pathol 2004;57:1033-7.
- 9 Gursan N, Gundogdu C, Albayrak A, Kabalar ME. Immunohistochemical detection of progesterone receptors and the correlation with Ki-67 labeling indices in paraffin-embedded sections of meningiomas. Int J Neurosci 2002;112:463-70.
- 10 Hilbig A, Barbosa-Coutinho LM. Meningiomas and hormonal receptors. Immunohistochemical study in typical and non-typical tumors. Arq Neuropsiquiatr 1998;56:193-9.
- 11 Shayanfar N, Mashayekh M, Mohammadpour M. Expression of progestrone receptor and proliferative marker ki 67 in various grades of meningioma. Acta Med Iran 2010;48:142-7.
- 12 Fewings PE, Battersby RD, Timperley WR. Long-term follow up of progesterone receptor status in benign meningioma: A prognostic indicator of recurrence? J Neurosurg 2000;92:401-5.
- 13 Verheijen FM, Donker GH, Viera CS, Sprong M, Jacobs HM, Blaauw G, et al. Progesterone receptor, bc1-2 and bax expression in meningiomas. J Neurooncol 2002;56:35-41.
- 14 Wahab M, Al-Azzawi F. Meningioma and hormonal influences. Climacteric 2003;6:285-92.
- 15 Walter LM, Rogers PA, Girling JE. The role of progesterone in endometrial angiogenesis in pregnant and ovariectomised mice. Reproduction 2005;129:765-77.
- 16 Wolfsberger S, Doostkam S, Boecher-Schwarz HG, Roessler K, van Trotsenburg M, Hainfellner JA, et al. Progesterone-receptor index in meningiomas: Correlation with clinico-pathological parameters and review of the literature. Neurosurg Rev 2004;27:238-45.