A Clinicopathological Study of Angiogenesis in Meningiomas Using Immunohistochemical Markers

Meningioma is a neoplasm arising from arachnoid cap cells and an important group of tumors of the meninges. The extent of surgical resection is one of the most important factors predicting recurrence along with histologic grading which in turn depends on factors such as the tumor site, vascularity, and peritumoral brain edema.

We studied the relationship between Vascular endothelial growth factor (VEGF) expression, angiogenesis, and peritumoral brain edema (PTBE) in different grades and subtypes of meningioma.

A cross-sectional study; comprising 48 confirmed meningioma cases. Immunohistochemistry was done using antibodies to VEGF, CD-105, and Ki-67. VEGF expression in tumor cells and endothelial cells was scored and microvessel density was calculated on CD105 stained slides. The MIB-1 labeling index was calculated to supplement the grading of the tumor. PTBE was classified from the MRI images.

In our study, meningioma occurred in the age range of 24-78 years with a mean of 53.23 years. The study population included 66.7% females and 33.3% males with an F:M ratio of 2:1. Transitional meningioma was the predominant histological subtype. We observed increased VEGF expression in transitional and meningothelial patterns and decreased expression in fibroblastic meningioma. High MVD score was shown only by cases with grade III PTBE and all cases with grade 0 and grade I PTBE showed low MVD score.

Microvessel density assessed by CD105 staining is increased in cases with peritumoral edema hence, it can be considered a marker for angiogenesis.