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Recurrent and atypical meningiomas--a multiparametric study using Ki67 labelling index, AgNOR and DNA Feulgen
F Ferraraccio1, M Accardo, F Giangaspero
1Department of Morphopathology, II University, Naples, Italy.
Objective:
Histological analysis has limited value to predict the biological behavior of meningiomas. In this study, we investigated the utility of indicators of cell proliferation in the evaluation of histologically benign meningiomas.
Materials And Methods:
For this purpose, 50 meningothelial meningiomas, 50 atypical meningiomas and 8 primary benign meningiomas with their recurrences were studied. For each case the Ki67 labeling index (LI), DNA ploidy and AgNOR were evaluated and the results quantitatively processed and assessed by computerized image analyzer.
Results:
The Ki67 labelling showed a low index (11.3%) in typical meningiomas and primary meningiomas (13.6%). In contrast, it was higher in atypical (26.6%) and recurrent meningiomas (28%). Similar results were obtained for the AgNOR granule count which showed that typical and primary meningiomas had mean 1.51 - 1.49, whereas recurring meningiomas and atypical meningiomas had mean values of 1.92 and 1.98, respectively. DNA ploidy revealed in the hyperpolyploid region between 4c - 16c: 7.02% of the nuclei in primary meningiomas, 17.98% of the nuclei in recurring meningiomas and 24.63% of the nuclei in atypical meningiomas.
Conclusion:
Our results suggest that evaluation of cell proliferation using Ki67 LI, DNA ploidy and AgNOr, integrated with standard histopathology, can provide better information for a correct grading of meningiomas.
Insights
Histological analysis of meningiomas is limited. Cell proliferation markers like Ki67 labeling index (LI), DNA ploidy, and AgNOR aid in grading meningiomas, improving diagnostic accuracy beyond standard histopathology.
Area of Science:
- Neuro-oncology
- Pathology
- Molecular Biology
Background:
- Standard histological analysis of meningiomas has limitations in predicting biological behavior.
- Accurate grading of meningiomas is crucial for determining prognosis and treatment strategies.
Purpose of the Study:
- To investigate the utility of cell proliferation indicators in evaluating histologically benign meningiomas.
- To assess the predictive value of Ki67 labeling index (LI), DNA ploidy, and AgNOR in meningioma grading.
Main Methods:
- Studied 50 meningothelial meningiomas, 50 atypical meningiomas, and 8 primary benign meningiomas with recurrences.
- Evaluated Ki67 LI, DNA ploidy, and AgNOR using a computerized image analyzer.
- Quantitatively processed and assessed results for each case.
Main Results:
- Ki67 LI was significantly higher in atypical (26.6%) and recurrent (28%) meningiomas compared to typical (11.3%) and primary (13.6%) meningiomas.
- AgNOR granule counts were higher in atypical (1.98) and recurrent (1.92) meningiomas than in typical (1.51) and primary (1.49) meningiomas.
- DNA ploidy analysis revealed increased hyperploid nuclei in atypical (24.63%) and recurrent (17.98%) meningiomas compared to primary (7.02%) meningiomas.
Conclusions:
- Ki67 LI, DNA ploidy, and AgNOR are valuable indicators of cell proliferation in meningiomas.
- Integrating these proliferation markers with standard histopathology improves the accuracy of meningioma grading.
- These markers offer better prognostic information for meningioma patients.