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MIB-1 staining index and peritumoral brain edema of meningiomas
1Department of Neurosurgery, Tokyo Women's Medical College Dai-ni Hospital, Tokyo, Japan.
Background:
Growth rates and tumor aggressiveness of meningiomas are thought to be closely related to brain edema development. However, histopathologic data alone are not consistently accurate predictors of the behavior and clinical course of a meningioma.
Methods:
The authors examined 57 histologically proven intracranial meningiomas to identify factors, including growth fractions determined by MIB-1 immunostaining, that may influence the development of meningioma-associated peritumoral brain edema. There were 54 benign, 2 atypical, and 1 anaplastic meningiomas. The MIB-1 staining index (SI) percentage was defined as the number of MIB-1 positive cells divided by the total number of tumor cells in a 1.037-square millimeter area on the slide. The extent of peritumoral brain edema was determined using preoperative magnetic resonance imaging. The extent of edema was classified as Grade 0,1, or 2 (GR0, GR1, or GR2), in order of increasing severity.
Results:
The MIB-1 SIs of the 57 cases ranged from 0.06-6.8% (median, 0.80%). There were 26 GR0, 20 GR1, and 11 GR2 edema cases. The MIB-1 SI rose in order of increasing edema severity. There was a statistically significant correlation between the MIB-1 SI and the extent of brain edema (P<0.0001), and also between the tumor size and the extent of brain edema (P=0.001). Meningothelial and atypical/anaplastic meningiomas were associated with peritumoral brain edema more often than any other subtype (P<0.005).
Conclusions:
Growth fractions, as determined by MIB-1 immunostaining, rise with increasing severity of peritumoral brain edema, indicating a close relationship between tumor aggressiveness and edema development.
Insights
Tumor aggressiveness in meningiomas correlates with brain edema. Higher MIB-1 staining index (growth fraction) indicates more severe edema, suggesting a link between tumor behavior and swelling.
Area of Science:
- Neuropathology
- Oncology
- Radiology
Background:
- Meningioma aggressiveness and growth rates are linked to brain edema.
- Histopathology alone is not always accurate for predicting meningioma behavior.
Purpose of the Study:
- To identify factors influencing meningioma-associated peritumoral brain edema.
- To assess the role of MIB-1 immunostaining (growth fraction) in edema development.
Main Methods:
- 57 intracranial meningiomas were analyzed.
- MIB-1 staining index (SI) quantified tumor growth fraction.
- Peritumoral brain edema extent was graded (GR0-GR2) using MRI.
Main Results:
- MIB-1 SI showed a statistically significant correlation with edema severity (P<0.0001).
- Tumor size also correlated significantly with edema extent (P=0.001).
- Meningothelial and atypical/anaplastic subtypes were more frequently associated with edema.
Conclusions:
- Growth fractions, measured by MIB-1 SI, increase with worsening peritumoral brain edema.
- This indicates a strong relationship between meningioma aggressiveness and edema development.