title: Status of Ki-67, estrogen and progesterone receptors in various subtypes of intracranial meningiomas.
abstract: Meningiomas are the most prevalent intracranial tumors in human being. Although, majority of these cases are of benign nature, malignant behavior might be seen in a number of patients. This study aimed to investigate the status of estrogen receptor, progesterone receptor and Ki-67 labeling index in different grades of surgical intracranial meningiomas. In this prospective study, 50 patients with intracranial meningiomas were operated at the department of neurosurgery, Tabriz Teaching Imam Reza Hospital; from February 2010 through January 2012. Tumor grade was determined histopathologically according to the World Health Organization (WHO) subtyping system. Status of estrogen and progesterone receptor, as well as the Ki-67 labeling index was determined by immunohistochemical approach and graded as 0 (absent), 1 (weak), 2 (moderate) and 3 (strong). The group of patients comprised 15 males (30%) and 35 females (70%) with a mean age of 71.76 +/- 10.20 (range: 49-87) years. WHO grades I, II and III tumors were reported in 68, 22 and 10% of the cases, respectively. Estrogen receptor, progesterone receptor and Ki-67 labeling index were detected in 20% (all grade 1), 98% (grade 1: 2%, grade 2: 22%, grade 3: 74%) and 38% (grade 1: 6%, grade 2: 22% and grade 3: 10%) of the cases, respectively. The rate of grade 1 estrogen receptor was significantly higher in WHO grade I tumors (29%) than in WHO grades II and III (zero for both, p = 0.02). Grade 2 progesterone receptor was significantly higher in WHO grade II tumors (72.7%) vs. WHO grades I (8.8%) or III (0%). On the other hand, the rate of grade 3 progesterone receptor was significantly higher in WHO grades I (85.3%) and III (100%) tumors than in WHO grade II (27.3%) (p = 0.01). The rate of grade 3 Ki-67 labeling index was significantly higher in WHO grade III tumors (100%) than in WHO grades I and II (zero for both, p < 0.001). This study showed that firstly, estrogen receptor is seldom expressed in patients with meningioma; however, its presence means a good prognosis. Secondly, Ki-67 labeling index is a marker of poor prognosis in these patients. Thirdly, although, progesterone receptors are frequently expressed in meningioma, their prognostic role varies greatly and needs to be determined in further studies.
authors.affiliation: Department of Pathology, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Fakhrjou
authors.forename: Ali
authors.initials: A
authors.lastname: Meshkini
authors.forename: Sepideh
authors.initials: S
authors.lastname: Shadrvan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D001932:Brain Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D020869:Gene Expression Profiling; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008579:Meningioma / Q000175:diagnosis / Q000378:metabolism*; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone