Histopathological Analysis and Correlation of Ki67 and Progesterone Receptor Status with WHO Grading In Meningiomas

Tamilselvi Veeramani,J Maheswari

doi:10.21276/apalm.1499

Tamilselvi Veeramani, J Maheswari

Open Access

https://doi.org/10.21276/apalm.1499

Copy DOI

Abstract

Background: Meningiomas are slow growing tumors that are among the most common of CNS neoplasms and form the most common CNS tumor to be reported above 35 years of age. Materials & Methods: This retrospective study was carried out in the Department of Pathology during the period of January2011 to May2013. A total of 50 cases were graded according to the WHO 2016 grading criteria. The biopsy specimens were fixed in 10% neutral buffered formalin, sections was stained with Hematoxylin & Eosin. Immunohistochemistry was done with Progesterone receptor and Ki67 antibodies for selected cases. Results: The incidence of meningiomas was 33.11% with a female sex predilection and most common in the 5th decade. Transitional meningioma was the most common variant to occur. The incidence of WHO Grade I, Grade II and Grade III meningiomas were 88%, 4% and 8% respectively. Comparison of Ki67 LI and PR score in various grades of meningiomas were done. The average Ki67 LI and PR score were 1.1%, 10.25; 6%, 3; 16%, 0 in grade I, II and III meningiomas respectively. p value showed a statistically significant difference between different grades of meningiomas with respect to PR and Ki67 status. Spearman correlation showed a clearly significant inverse relationship between the two antibodies. Conclusion: The use of immunohistochemical markers aids in determining the aggressive nature of the tumor, its recurrence potential and can be used as prognostic markers.

Highlights

Meningiomas are a diverse group of neoplasms derived from the arachnoidal cap cells lining the meninges and their extensions of dura
The most common variant (Tab.1) reported in our study is the transitional subtype accounting for 48% and the second most common variant being meningothelial meningioma with an incidence of 20% (10 cases)
Grade I meningiomas were the predominant subtype to occur with an overall incidence of 88% (44 cases)

Summary

Introduction

Meningiomas are a diverse group of neoplasms derived from the arachnoidal cap cells lining the meninges and their extensions of dura. According to the CBTRUS statistics 2012, meningiomas constitute to 35% of all CNS tumors and the 5yr survival rate being 70% for benign and 55% for malignant meningiomas.[2] Based upon the WHO 2016 grading, meningiomas are classified as grade I, grade II (atypical) and grade III (anaplastic meningiomas). The various parameters taken into consideration for histological grading include: Cellularity , Mitotic index , Sheet like or small cell pattern, Macronucleoli with nuclear pleomorphism and Tumor necrosis.[3]The Armed Forces Institute of Pathology declared that the criteria for malignancy in meningiomas are satisfied when the tumor displays either or both features of anaplasia and brain parenchyma invasion. Brain-invasive meningiomas are considered as equivalent to WHO Grade II neoplasms.[4] In the 2016. Meningiomas are slow growing tumors that are among the most common of CNS neoplasms and form the most common CNS tumor to be reported above 35 years of age

Methods

Results

Conclusion