title: Prognostic significance of p53 and p21WAF1/CIP1 immunoreactivity and tumor micronecrosis for recurrence of meningiomas.
abstract: Recurrence is an important factor for prognosis of meningioma patients, this also occurring with some lesions diagnosed histopathologically as benign. To analyze their relationships with clinicopathological factors, p53 and p21WAF1/CIP1 immunoreactivity, 80 meningiomas were classified into four groups with regard to the World Health Organization (WHO) histological classification and recurrence: 40 cases of Group I (typical type)-NR (no recurrence); five cases of Group I-R (recurrence); 20 cases of Group II (atypical or anaplastic type)-NR and 15 cases of Group II-R. Micronecrosis was detected in 25% of Group II-NR and 73.3% of Group II-R (P = 0.007, odds ratio (OR) = 8.25, 95% confidence interval (CI) = 1.79-38.01). Patients receiving radiation therapy had a lower risk of recurrence (P = 0.041, OR = 0.20, 95% CI = 0.05-0.85). Immunoreactivity for p53 protein was positive in 22% of Group I and 54% or Group II (P = 0.005), and in 80% of Group I-R and 15% of Group I-NR (P = 0.006, OR = 22.7, 95% CI = 2.15-239.4). p21WAF1/CIP1 protein was detected in 22% of Group I and 48% of Group II (P = 0.017), but with no link to recurrence. Multivariate analysis also showed p53 immunoreactivity in Group I (benign lesions) and micronecrosis in Group II (atypical/anaplastic meningiomas) to be strong prognostic factors for recurrence (P < 0.05). These results indicate that p53 immunoreactivity and micronecrosis can help predicting recurrence of meningiomas.
authors.affiliation: Department of Neurosurgery, Mie University School of Medicine, Tsu, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kamei
authors.forename: M
authors.initials: M
authors.lastname: Watanabe
authors.forename: T
authors.initials: T
authors.lastname: Nakayama
authors.forename: K
authors.initials: K
authors.lastname: Kanamaru
authors.forename: S
authors.initials: S
authors.lastname: Waga
authors.forename: T
authors.initials: T
authors.lastname: Shiraishi
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D050759:Cyclin-Dependent Kinase Inhibitor p21; D016213:Cyclins / Q000032:analysis*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D008579:Meningioma / Q000737:chemistry / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D008875:Middle Aged; D009336:Necrosis; D009361:Neoplasm Invasiveness; D009363:Neoplasm Proteins / Q000032:analysis*; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012306:Risk; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; C493956:CDKN1A protein, human; D050759:Cyclin-Dependent Kinase Inhibitor p21; D016213:Cyclins; D009363:Neoplasm Proteins; D016159:Tumor Suppressor Protein p53