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MIB-1 staining index of pediatric meningiomas
D I Sandberg1, M A Edgar, L Resch
1Division of Neurosurgery, New York Presbyterian Hospital and the Weill Medical College of Cornell University, New York, USA.
Objective:
For adult meningiomas, the staining index (SI) for the anti-Ki-67 monoclonal antibody MIB-1 is well correlated with histological atypia and tumor recurrence. MIB-1 SIs for meningiomas in the pediatric population have not been previously reported. Meningiomas tend to be more histologically aggressive and to recur more frequently in children, compared with adults. The objectives of this study were to determine whether MIB-1 SIs are correlated with pathological atypia and recurrence among pediatric meningiomas and to compare the MIB-1 SIs of pediatric meningiomas with those of adult meningiomas.
Methods:
MIB-1 SIs were assessed on paraffin-embedded sections of 14 pediatric meningiomas (patient age, 2-17 yr), 5 of which contained atypical or malignant features. For comparison with benign pediatric meningiomas, MIB-1 SIs were also assessed on paraffin-embedded sections of 14 adult meningiomas (patient age, 38-90 yr), none of which displayed atypical or malignant features or recurred within a 5-month median follow-up period.
Results:
MIB-1 SIs of pediatric meningiomas ranged from 1.2 to 31.6% (median, 9.1%). Significant differences were observed between the MIB-1 SIs for tumors with atypical or malignant features (median, 12.3%; range, 7.0-31.6%) and those for tumors without atypia (median, 7.0%; range, 1.2-12.6%; P = 0.045). There were six recurrences after gross total resection, during a 36.5-month median follow-up period. All five of the tumors with pathological atypia recurred; one tumor without atypia recurred. Significant differences were observed between MIB-1 SIs for nonrecurrent tumors (median, 6.6%; range, 1.2-12.2%) and those for recurrent tumors (median, 12.5%; range, 7.0-31.6%; P = 0.012). The median MIB-1 SI for adult control specimens was 8.8% (range, 1.2-19.3%), which did not differ significantly from that for pediatric meningiomas without atypia (P = 0.68).
Conclusion:
For this cohort of pediatric meningiomas, pathological atypia and the tendency to recur were correlated with elevated MIB-1 SIs. The median MIB-1 SI for pediatric meningiomas without histological atypia did not differ significantly from that for adult meningiomas without atypia, suggesting that the more aggressive clinical features of meningiomas in children may be attributable to factors other than the rate of cellular proliferation.
Insights
Pediatric meningiomas with atypical features show higher MIB-1 staining index (SI) and recurrence rates. Elevated MIB-1 SI in pediatric meningiomas correlates with atypia and recurrence, but not necessarily with increased proliferation compared to adults.
Area of Science:
- Neuro-oncology
- Pediatric oncology
- Pathology
Background:
- Meningiomas are tumors arising from the meninges.
- In adults, the MIB-1 staining index (SI) correlates with meningioma aggressiveness.
- Pediatric meningiomas often exhibit more aggressive behavior and higher recurrence rates than adult counterparts.
Purpose of the Study:
- To investigate the correlation between MIB-1 SI, pathological atypia, and recurrence in pediatric meningiomas.
- To compare MIB-1 SIs in pediatric and adult meningiomas.
Main Methods:
- Assessed MIB-1 SIs on paraffin-embedded sections of 14 pediatric meningiomas (ages 2-17).
- Included 5 pediatric tumors with atypical/malignant features.
- Compared with 14 adult meningiomas (ages 38-90) without atypia or recurrence.
Main Results:
- Pediatric meningiomas had MIB-1 SIs ranging from 1.2% to 31.6% (median 9.1%).
- Tumors with atypical/malignant features showed significantly higher MIB-1 SIs (median 12.3%) than those without (median 7.0%, P=0.045).
- Recurrent tumors (median 12.5%) had significantly higher MIB-1 SIs than non-recurrent tumors (median 6.6%, P=0.012).
- Median MIB-1 SI for adult controls (8.8%) did not differ significantly from pediatric meningiomas without atypia (P=0.68).
Conclusions:
- MIB-1 SI is correlated with pathological atypia and recurrence in pediatric meningiomas.
- The similar MIB-1 SI in non-atypical pediatric and adult meningiomas suggests other factors contribute to the increased aggressiveness of pediatric meningiomas.