Histomorphological Study And Grading Of Meningiothelial Neoplasms Using Ki 67 Proliferation Marker, Comparative Study Of Behavioral Outcome In Cranial And Extra Cranial Meningiomas At A Tertiary Care Centre
Keywords:
Meningioma, Mitosis, Tumor, Grade. Key message: MIB assessment to know behavioral outcome in plays an important role in patients of low socioeconomic strata, where financial constraint s are seen for cytogenetic studies. Grade III meningioma showed significant recurrence, and extra cranial meningiomas with high MIB had poor outcome and recurrenceAbstract
Background:Meningeal neoplasms are slow growing tumors arising from meningothelial cells of arachnoid matter. It constitutes about 36% of all CNS tumors and are driven by chromosome 22q alterations (e.g. NF2, SMARCB1) and arise in neural crest cell derived meninges. Over 15, WHO morphological variants have been described. Common clinical symptoms include headache, weakness, and visual disturbances. Prognosis of the cases depends a large extent on histological subtypes, Ki 67, extent of surgery,atypical features, chromosomal loss and associated mutations. Somatostatin receptor 2a, epithelial membrane antigen (EMA) and Progesterone receptors are specific marker of meningioma.
Methods:The study comprised of a retrospective analysis of biopsy specimens of meningiomas that was studied over a period of 2 yearsat a tertiary care centre.
Histologial categorization and Ki 67staining were done and studied in correlation with various paramenters of importance like site,recurrence,presenting symptoms and signs, clinical outcome. Conclusion:Meningioma grade I was more prevalent and had a benign biological behavior while grade III was least prevalent in our study and showed recurrence, brain invasion and atypical histological features. Extra cranialbehaved more aggressively and constituted 5 %. Most of recurrent meningiomas were in the atypical meningioma category or WHO grade III category. Few symptoms and signs also varied with particular histological subtypes.
Histological variants and MIB index correlated well in our study.Hot-spot based examination was done and in patients with higher Ki 67, close follow up was done and showed significant
3recurrence (grade III). It is highly recommended that Ki67 need to be assessed in all cases of meningiomas in addition to pattern analysis, to know the biological behavior pattern.
