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Invasive meningioma: a tumour with high proliferating and "recurrence" potential
1Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Abstract:
A study was undertaken to investigate the correlation between histological invasiveness and proliferating potential and clinical recurrence in meningioma. In 39 meningiomas, the histological findings at the tumour-brain interface zone were classified into 3 types, consisting of 29 cases of non-invasion (NON). 7 cases of nodular invasion (NOD), and 3 cases of intermingled invasion (INT). Proliferating cell nuclear antigen (PCNA) and argyrophilic nucleolar organizer region (AgNOR) indices were studied. PCNA indices (mean +/- standard error) of NON, NOD. and INT were 1.7 +/- 0.1%, 5.2 +/- 0.5%, and 7.5 +/- 0.7%. respectively, and the AgNOR indices (dot number/nucleus) were 1.50 +/- 0.03, 2.00 +/- 0.04, and 2.22 +/- 0.07, respectively. Significant differences were found among the three types in both parameters. Clinically, tumour recurrence was observed in 1/29 NON, 4/7 NOD, and 2/2 INT cases, indicating a higher incidence of recurrence in invasive meningiomas (NOD plus INT). Four of 32 patients who underwent gross total removal of the tumours showed recurrence, and all of these four tumours were invasive meningiomas. The results of the present study showed that tumour invasiveness as measured by PCNA + AgNOR indices correlated well with high proliferative potential and clinical recurrence.
Insights
Histological invasiveness in meningioma, assessed by proliferating cell nuclear antigen (PCNA) and argyrophilic nucleolar organizer region (AgNOR) indices, correlates with higher recurrence rates. Invasive meningiomas show increased proliferation and a greater likelihood of clinical recurrence.
Area of Science:
- Neuro-oncology
- Surgical pathology
- Tumor biology
Background:
- Meningiomas are tumors arising from the meninges.
- Histological invasiveness is a key factor in meningioma behavior.
- Proliferative potential influences tumor aggressiveness and recurrence.
Purpose of the Study:
- To investigate the correlation between histological invasiveness and proliferative potential in meningiomas.
- To determine the relationship between invasiveness, proliferation, and clinical recurrence of meningiomas.
Main Methods:
- Histological classification of tumor-brain interface into non-invasion (NON), nodular invasion (NOD), and intermingled invasion (INT) in 39 meningiomas.
- Assessment of proliferating cell nuclear antigen (PCNA) and argyrophilic nucleolar organizer region (AgNOR) indices.
- Correlation of invasiveness and proliferation indices with clinical recurrence data.
Main Results:
- Significantly higher PCNA and AgNOR indices were observed in invasive (NOD and INT) compared to non-invasive (NON) meningiomas.
- Tumor recurrence rates were higher in invasive meningiomas (NOD and INT) than in non-invasive ones.
- All recurrent tumors after gross total removal were classified as invasive.
Conclusions:
- Tumor invasiveness, quantified by PCNA and AgNOR indices, is a reliable indicator of high proliferative potential in meningiomas.
- Histological invasiveness is strongly associated with increased risk of clinical recurrence.
- Invasive meningiomas require closer monitoring and potentially tailored treatment strategies.