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Published on: July 31, 2017
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Correlations between surface marker patterns in meningiomas, prognosis and location.
Nadja Blum1, Simon Skyrman2, Abiel Orrego3
1Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.
Summary
Progesterone receptor (PR) expression may predict meningioma patient survival, while other tested markers like VEGF and CD34 did not show prognostic value. Recurrence remains a significant cause of death in meningioma patients.
Area of Science:
- Neuro-oncology
- Tumor biomarkers
- Clinical outcome research
Background:
- Meningiomas show variable behavior within WHO grades, necessitating better prognostic markers.
- Existing markers like Ki-67 and TERT mutations are often based on retrospective data.
- Need for validated biomarkers to guide long-term meningioma management.
Purpose of the Study:
- To evaluate the prognostic significance of a panel of biomarkers in meningioma patients.
- To correlate marker expression with long-term outcomes including recurrence and mortality.
- To identify reliable biomarkers for risk stratification in meningioma.
Main Methods:
- Analysis of 176 meningiomas (159 WHO grade 1, 16 WHO grade 2, 1 WHO grade 3) from a previous study.
- Long-term follow-up (>10 years) assessing recurrence, tumor location, and patient death.
- Correlation analysis between marker expression (GHr, Igf1r, PR, CD34, AR, EGFR, caspase 3, VEGF) and clinical outcomes.
Main Results:
- Tumor recurrence observed in 27/155 WHO grade 1 and 5/15 WHO grade 2 meningiomas.
- 10-year mortality was 10.8% (WHO G1) and 53.4% (WHO G2), with ~50% disease-specific.
- Significant negative correlation between PR expression and tumor-related death (p=0.001).
- Higher Ki-67 in patients dying from tumor (8% vs 4%, p=0.001).
- PR expression linked to central/skull base location (p=0.0002).
Conclusions:
- Tumor recurrence is a major cause of mortality in meningiomas, even with benign grading.
- Expression of GHr, Igf1r, CD34, EGFR, caspase 3, and VEGF were not found to be clinically relevant biomarkers.
- Progesterone receptor (PR) expression and Ki-67 index show potential as prognostic indicators.
