Association between ki67 and PR Expression in Grades of Meningioma and its Prognosis

Abstract

Introduction: Meningioma is the very important type of tumor that occur in central nervous system (CNS)that represented 1/3 of whole tumor of CNS. In USA 97/100,000, persons recorded have meningioma. With170,000 patients detected as meningioma. The aim of study is the aim of the present study is to evaluate theuse of immunhistochemical expression of PR and ki67 for predicting the grades of meningioma, which areimportant in their prognosis, and line of treatment.Method: Ninety patients with meningioma were collected from the Neurosurgical Hospital-Baghdad, duringthe period from January 2017 to January 2020. The data for cases were collected to study the age, genderand grade of tumor. Staining hematoxylin/Eosin (H plus E) for histological inputting and classifying of thetumors and immunohistochemically workup for PR & Ki67 done.Results: Cross sectional study for 90 patients with age, mean (44 ± 12) years old, in current study 64% ofpatients was females and 36% of patients was males, strong positive PR expression represented 50% ofpatients, 79% of patients have low Ki 67, 15% of them have intermediate Ki67 and 6% of patients with highKi67. Most of patients with age group 40-59 years old (51%). The mean and SD of Ki67 in (%) accordingto grades of meningioma I, II and III as following: (0.3 ± 0.07), (7 ± 5.9) and (38 ± 0.07) respectively.There is significant association between grades of meningioma and PR expression; 71% of grade I withPR expression strongly positive, 23% of grade II with PR expression were weakly positive and 100% ofgrade III with PR expression were negative. In addition, there is significant association between grades ofmeningioma and prognosis; 100% of grade I with good prognosis, 100% of grade II with fair prognosis and100% of grade III with poor prognosis. In current study, also there is significant association between gradesof meningioma and Ki67; 100% of grade I with low level of Ki67, 100% of grade III with high level of Ki67and 64% of grade II with intermediate level of Ki67. There is no significant association between age andgender with grades of meningioma.Conclusion: The mean Ki-67 was significantly more in meningioma grade III than in patients with gradesII and I as WHO classification. There is strong expression of PR was found mainly in the grade I typicalmeningioma group. Utilization of markers for proliferation (ki-67 labeling index) and hormonal expression(Progesterone Receptor) in combination with histopathological features may help in the identification ofbiologically aggressive meningioma.