A Study of Progesterone Receptor (PR) Expression in Meningiomas, and its Correlation with Clinicopathological Parameters

Abstract

BACKGROUND: Meningiomas are the most common benign CNS neoplasms with higher prevalence in women. Clinical & epidemiological data reveal that Meningiomas are hormone sensitive tumours and they have been found to express hormonal receptors. AIMS AND OBJECTIVES: This study deals with the histomorphological characteristics and the immunohistochemical expression of Progesterone receptor (PR) in Meningiomas in correlation with various clinicopathological parameters. MATERIALS AND METHODS: This study analyzes the histopathological characteristics of 209 consecutively operated Meningiomas over a period of three years. Immunohistochemical study with monoclonal antibodies to PR was done only for 60 randomly selected cases. The PR expression in relation to age and sex of patient, site and various histopathological grades of the tumour, and their rates of recurrence were studied. RESULTS: Histopathological features such as small cell change, hypercellularity, sheet like pattern, nuclear pleomorphism, macronucleoli, high mitotic rates, necrosis and brain invasion were seen predominantly in high grade Meningiomas than benign Meningiomas. Immunohistochemical analysis revealed PR expression in 66.7% of cases. In comparison with grade I Meningiomas the PR expression in high grade and also recurrent Meningiomas were found to be from weak to absent, thereby showing a positive association between low rates of expression of PR and increased tumour aggressiveness. CONCLUSION: It is concluded that expression of progesterone receptors by the tumour in correlation with other histopathological features such as histological grade of the tumour, brain invasion and mitotic rates have been considered as a useful prognostic tool in assessing the behaviour of Meningiomas.