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Bromodeoxyuridine labeling study of intracranial meningiomas: proliferative potential and recurrence
K S Lee1, T Hoshino, L A Rodriguez
1Department of Neurological Surgery, School of Medicine, University of California, San Francisco 94143.
Abstract:
Ninety-six patients with intracranial meningiomas and two with hemangiopericytic variants received a 30-min intravenous infusion of bromodeoxyuridine (BrdUrd), 200 mg/m2, before tumor removal. Excised tumor specimens were stained by the indirect immunoperoxidase method to determine the BrdUrd labeling index (LI), or percentage of cells in DNA synthesis. The BrdUrd LI was less than 1% in 63 (86.3%) of 73 nonmalignant meningiomas and less than 1% in 20 (87%) of 23 malignant meningiomas. Of 23 malignant meningiomas 11 were recurrent tumors; 8 patients had recurrence 3 to 33 months after the study. The recurrence rate was 100% (five of five) in patients whose tumors had a BrdUrd LI greater than 5%, 44% (11 of 25) in those with a BrdUrd LI 1% to 5%, and 6.1% (4 of 66) in those with an LI less than 1%. Thus, meningiomas with a BrdUrd LI greater than 1% may grow faster and recur more frequently. Among patients with malignant meningiomas, the mean time to recurrence after the study was 7.5 months in those with a BrdUrd LI greater than 5% and 20.2 months for those with an LI 1% to 5%. The mean time to recurrence was 97.8 months in patients with nonmalignant meningiomas. Both hemangiopericytic variants were recurrent and showed LIs of 0.5% and 4.1%; the former tumor recurred 8 years after complete resection, while the latter recurred three times in 3.5 years. Thus, the proliferative potential of intracranial meningiomas as reflected by the BrdUrd LI appears to be a prognostic variable that can help to elucidate the biological behavior of individual meningiomas.
Insights
Bromodeoxyuridine (BrdUrd) labeling index (LI) can predict meningioma recurrence. High BrdUrd LI indicates faster growth and more frequent recurrence in intracranial meningiomas, aiding in prognosis.
Area of Science:
- Neuro-oncology
- Cellular biology
- Tumorigenesis
Background:
- Intracranial meningiomas are common primary brain tumors.
- Accurate prognostic markers are crucial for managing meningioma recurrence.
- Bromodeoxyuridine (BrdUrd) is a thymidine analog used to assess cell proliferation.
Purpose of the Study:
- To evaluate the prognostic value of the BrdUrd labeling index (LI) in intracranial meningiomas.
- To correlate BrdUrd LI with tumor recurrence and biological behavior.
Main Methods:
- Ninety-six patients with meningiomas received BrdUrd infusion before surgery.
- Tumor specimens were analyzed for BrdUrd LI using immunoperoxidase staining.
- LI was correlated with tumor grade, recurrence rates, and time to recurrence.
Main Results:
- Most meningiomas (nonmalignant and malignant) showed a BrdUrd LI < 1%.
- Malignant meningiomas with LI > 5% had a 100% recurrence rate.
- Tumors with LI > 1% demonstrated faster growth and more frequent recurrence compared to those with LI < 1%.
Conclusions:
- The BrdUrd LI is a significant prognostic variable for intracranial meningiomas.
- BrdUrd LI can help predict the proliferative potential and recurrence risk of individual meningiomas.
- This marker aids in understanding the biological behavior and guiding clinical management of meningiomas.