Phosphohistone-H3 Proliferation Index Is Superior to Mitotic Index and MIB-1 Expression as a Predictor of Recurrence in Human Meningiomas.
OBJECTIVE
This study investigated the prognostic value of the phosphohistone-H3 (PHH3) proliferation index (PI) in human meningiomas and compared the reliability with the conventional mitotic index and MIB-1 biomarker.


METHODS
Proliferative activity was determined in 160 patients by standardized immunohistochemistry on tissue microarrays and related to recurrence.


RESULTS
All three proliferation assessment methods were significantly associated with World Health Organization grade. The optimal cutoff values for recurrence prediction were 3% for the MIB-1 PI and 0.5% for the PHH3 PI. Increased PHH3 PI was significantly associated with recurrence-free survival in univariate Cox proportional hazards regression analysis (P = .011) and remained an independent predictor in multivariate analysis (P = .005). Mitotic index and MIB-1 PI did not reach statistical significance.


CONCLUSIONS
PHH3 immunostaining allowed for the easiest, fastest, and most objective assessment of proliferation and proved to be the most accurate and reliable method for predicting recurrence in patients resected for meningiomas.
From the Departments of Laboratory Medicine, Children's and Women's Health, theolw@stud.ntnu.no.
Theo L
TL
Winther
From the Departments of Laboratory Medicine, Children's and Women's Health.
Magnus B
MB
Arnli
Cancer Research and Molecular Medicine.
Øyvind
Ø
Salvesen
From the Departments of Laboratory Medicine, Children's and Women's Health, Pathology and Medical Genetics, St Olavs Hospital, Trondheim, Norway.
Sverre H
SH
Torp
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006657:Histones / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008577:Meningeal Neoplasms / Q000378:metabolism / Q000473:pathology*; D008579:Meningioma / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D008940:Mitotic Index; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology*; D010766:Phosphorylation; D011379:Prognosis; D012189:Retrospective Studies
D006657:Histones; D019394:Ki-67 Antigen
Ki-67; Meningioma; PHH3; Prognosis; Recurrence-free survival