FOXM1 and β-catenin in meningiomas

Abstract

Objectives Forkhead box protein M1 (FOXM1) is a recently recognized biologic marker of increased cell proliferation and poor clinical outcomes in meningiomas. Alterations of Wnt signaling pathway, involving β-catenin, is one of FOXM1 key mechanisms and plays a pivotal role in meningioma progression. In this study, we aimed to analyze the expression of FOXM1, β-catenin, and Ki-67 in meningiomas of different WHO grades and correlated such expression with proliferation indices and tumor recurrence. This would delineate any potential predictive/prognostic value of these markers and investigate their eligibility as targets in meningioma therapy. Materials and methods We studied the immunohistochemical expression of FOXM1, β-catenin, and Ki-67 in 91 meningiomas: 43 WHO grade I, 34 WHO grade II, and 14 WHO grade III meningiomas. Results A statistically significant higher FOXM1 expression was reported with increasing WHO meningioma grade. β-catenin expression was lower in meningiomas WHO grade II/III than WHO grade I, and a significant association between lower β-catenin expression and tumor recurrence was detected. Increased FOXM1 expression correlated with tumor recurrence probability, increased proliferation indices, and lower β-catenin expression. Conclusion The study highlighted the patterns of FOXM1 and β-catenin in meningiomas. There was a trend for FOXM1 upregulation in high-grade and aggressive meningiomas, suggesting its consideration as a therapeutic target in cases with poor response to current management options. We also emphasize the potential roles of β-catenin in meningioma progression and recurrence.