Abstract
Meningiomas are common primary brain tumors. However, they are often complicated by significant peritumoral brain edema, which leads to surgery difficulties and prolonged hospitalization. The aim of this study was to evaluate the presence of mast cells and expression of hypoxia inducible factor-1 (HIF-1) in correlation with the grade of meningioma and presence of peritumoral brain edema. Immunohistochemistry was performed with specific antibodies against tryptase (mast cells) and HIF-1 in low grade meningiomas (estimated as G1) and high grade meningiomas (estimated as G2 or G3). Peritumoral brain edema observed in MRI was graded using Steinhoff classification. Tryptase expression was observed in 40.4 % low grade meningiomas and in 90 % high grade cases; HIF-1 in 55.7 % low grade and in 84 % high grade meningiomas. There was a statistically significant correlation between HIF-1 and tryptase expression in both groups (p = 0.003). Presence of peritumoral brain edema statistically correlated with tryptase (p = 0.001) and HIF-1 expression (p = 0.004). Mast cells as well as hypoxia are involved in meningioma progression, and may be associated with the formation of peritumoral brain edema leading to surgery complication and recovery. Therefore, they may be useful markers in predicting the clinical course of meningioma cases.
Highlights
Mast cells are multi-effector cells, they are still the least understood components of the immune system [1]
The aim of this study was to evaluate the presence of mast cells and expression of hypoxia inducible factor-1 (HIF-1) in correlation with the grade of meningioma and presence of peritumoral brain edema
Peritumoral brain edema was observed in 103 out of 154 meningiomas (66.8 %). 57 cases presented small peritumoral brain edema limited to 2 cm (I° Steinhoff classification), 44 covered less than half of the hemisphere (II° Steinhoff classification), and only two presented extensive peritumoral edema covering more than half of the hemisphere (III° Steinhoff classification) (Fig. 1)
Summary
Mast cells are multi-effector cells, they are still the least understood components of the immune system [1]. The importance and fascinating biology of mast cells has been described in many physiological and pathological conditions, but the role of mast cells in tumor development and progression is still unknown [2]. Mast cells (MCs) are often present in large amounts in the stroma of different neoplasms, such as: mammary adenocarcinoma, colorectal adenocarcinoma, urothelial carcinoma, neurofibroma or melanoma [3]. Much data postulated that MCs may affect tumor development in few different ways: by affecting tumor cells directly, by modulating the tumor microenvironment, or by activating other inflammatory cells beneficial for tumor progression [3, 4]. Histamine could affect tumor progression by inducing proliferation through H1 receptor and suppressing the immune system via the H2 receptor. It was discovered that histamine and tryptase concentrations positively correlate with mast cell count in mammary carcinomas [7]
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