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Published on: August 13, 2017
Lack of alkaline phosphatase activity predicts meningioma recurrence
Corinne Bouvier1, Agnès Liprandi, Carole Colin
1Department of Pathology, Faculty of Medicine, Timone Hospital, Marseille, France.
Abstract:
Meningiomas usually are benign intracranial tumors. However, some recur despite gross total resection, invade surrounding structures, or, rarely, metastasize. Reduced expression of the nonspecific tissue-type alkaline phosphatase (Pal) has been reported in high-grade meningiomas. To search for a predictor for recurrence, we studied Pal expression by histoenzymology in a series of 54 meningiomas with gross total removal. Pal expression was mostly altered in grades II and III meningiomas (P = .000014) and meningiomas with high MIB-1 values (P = .001). Pal expression correlated with cytogenetic data (P = .000033) and with recurrence (P = .0064); all tumors that recurred had abnormal Pal expression (13/13). In univariate analysis, Pal expression was the only variable correlated with recurrence-free survival (P = .035). Histochemical detection of Pal is a useful, easy, and low-cost technique to predict recurrence in meningiomas.
Insights
Reduced expression of tissue-type alkaline phosphatase (Pal) predicts meningioma recurrence. Histochemical detection of Pal is a simple, cost-effective method to identify tumors likely to return after surgery.
Area of Science:
- Neurology
- Oncology
- Biochemistry
Background:
- Meningiomas are typically benign intracranial tumors, but some exhibit aggressive behavior, including recurrence, invasion, and metastasis.
- Reduced expression of tissue-type alkaline phosphatase (Pal) has been associated with high-grade meningiomas.
Purpose of the Study:
- To investigate tissue-type alkaline phosphatase (Pal) expression as a predictor for meningioma recurrence.
- To evaluate the utility of histoenzymology for assessing Pal expression in meningiomas.
Main Methods:
- Studied Pal expression using histoenzymology in 54 meningiomas after gross total resection.
- Correlated Pal expression with tumor grade, MIB-1 values, cytogenetic data, and recurrence status.
Main Results:
- Pal expression was significantly altered in grades II and III meningiomas and those with high MIB-1 values.
- Abnormal Pal expression strongly correlated with cytogenetic abnormalities and tumor recurrence (13/13 recurrent tumors showed abnormal Pal expression).
- Pal expression was the sole significant predictor of recurrence-free survival in univariate analysis.
Conclusions:
- Histochemical detection of Pal is a valuable, accessible, and economical method for predicting meningioma recurrence.
- Assessing Pal expression can aid in identifying patients at higher risk for tumor recurrence.
