title: MCM7 expression is a promising predictor of recurrence in patients surgically resected for meningiomas.
abstract: Patients with high risk of recurrence after meningioma resection might benefit from adjuvant radiation therapy and closer clinical follow-up. While the World Health Organization (WHO) classification and the MIB-1 biomarker are applied in the clinical practice to identify these patients, the reliability of these methods is questionable. To improve the prediction of tumor recurrence, this study evaluated and compared the prognostic usefulness of the biomarker MCM7 with the conventional mitotic index and the MIB-1 biomarker. One hundred sixty patients were retrospectively analyzed. The expression of MIB-1 and MCM7 was determined as proliferative indices (PI-percentage of positive immunoreactive cells among 1000 tumor cells) in tissue microarrays. MCM7 PI revealed significantly higher indices in recurrent meningiomas compared with non-recurrent meningiomas (p = 0.020), while mitotic index and MIB-1 PI did not reach statistical significance (p ≥ 0.547). The optimal cutoff values for recurrence prediction were 3% for MIB-1 PI and 8% for MCM7 PI. MCM7 PI was significantly associated with recurrence-free survival in COX multivariate survival analyses (p = 0.005), while no association was found with mitotic index or MIB-1 (p ≥ 0.153). MCM7 PI allowed for the most accurate prediction of recurrence, obtaining the highest sensitivity and the greatest area under the ROC curve. These results proved that MCM7 PI is a better method for identifying patients with risk of recurrence compared with the traditional methods used in the current clinical practice. MCM7 may thus improve diagnostics, prediction of prognosis and treatment decision making in patients suffering from meningiomas.
authors.affiliation: Departments of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Erling Skjalgssons gate 1, 7030, Trondheim, Norway. theolw@stud.ntnu.no.
authors.forename: Theo L
authors.identifier: 0000-0002-3976-7490
authors.initials: TL
authors.lastname: Winther
authors.affiliation: Departments of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Erling Skjalgssons gate 1, 7030, Trondheim, Norway.|Pathology and Medical genetics, St. Olavs Hospital, Erling Skjalgssons gate 1, 7030, Trondheim, Norway.
authors.forename: Sverre H
authors.initials: SH
authors.lastname: Torp
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D049109:Cell Proliferation; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008577:Meningeal Neoplasms / Q000378:metabolism* / Q000601:surgery; D008579:Meningioma / Q000378:metabolism* / Q000601:surgery; D008875:Middle Aged; D064168:Minichromosome Maintenance Complex Component 7 / Q000378:metabolism*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000378:metabolism*; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; C101624:MCM7 protein, human; D064168:Minichromosome Maintenance Complex Component 7
keywords: Brain tumors; Immunohistochemistry; MCM; MIB-1; Prognosis; Proliferation