title: Prediction of recurrence in histologically benign meningiomas: proliferating cell nuclear antigen and Ki-67 immunohistochemical study.
abstract: BACKGROUND
  Recurrence in individual patients after complete surgical removal of meningiomas cannot be predicted by histology alone because recurrence occurs even in histologically benign meningiomas.
  
  
  METHODS
  We investigated proliferating cell nuclear antigen (PCNA) and Ki-67 labeling indices of histologically benign meningiomas in 95 patients to assess their relationship to recurrence. The labeling index (LI) was expressed as the percentage of tumor cell nuclei immunoreactive for PCNA or Ki-67 to total tumor nuclei counted per section. The cases/specimens comprised the following two groups: (1) nonrecurrent group: 82 specimens from 82 patients without recurrence, (2) recurrent group: 28 specimens from 10 patients with recurrence.
  
  
  RESULTS
  Proliferative activities or aggressiveness do not always develop with every recurrence in recurrent meningiomas. The PCNA LI was significantly higher in the recurrent group (3.98% +/- 0.37%) than in the nonrecurrent group (0.71 +/- 0.13%) (p < 0.0001). The Ki-67 LI also was significantly higher in the recurrent group (3.15 +/- 0.40%) than in the nonrecurrent group (0.39 +/- 0.07%) (p < 0.0001). There was a good correlation between the PCNA LI and the Ki-67 LI (coefficient of correlation r = 0.79, p < 0.001).
  
  
  CONCLUSIONS
  The results of our study suggested that a PCNA or Ki-67 LI of more than 2% may represent an increased risk for recurrence; therefore, we suggest that radiotherapy or stereotactic radiosurgery should be considered, even for histologically benign meningiomas.
authors.affiliation: Department of Neurosurgery, Fukui Medical School, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Takeuchi
authors.forename: T
authors.initials: T
authors.lastname: Kubota
authors.forename: M
authors.initials: M
authors.lastname: Kabuto
authors.forename: R
authors.initials: R
authors.lastname: Kitai
authors.forename: J
authors.initials: J
authors.lastname: Nozaki
authors.forename: J
authors.initials: J
authors.lastname: Yamashita
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis*; D008297:Male; D008577:Meningeal Neoplasms / Q000276:immunology* / Q000473:pathology; D008579:Meningioma / Q000276:immunology* / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000276:immunology*; D011237:Predictive Value of Tests; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis*
chemical_list: D019394:Ki-67 Antigen; D018809:Proliferating Cell Nuclear Antigen