Role of progesterone receptor expression and proliferative activity in predicting the recurrence of meningioma

Abstract

Introduction A putative role for progesterone in the growth of meningioma has been suggested. The aim of this study was to attest the role of progesterone receptor (PR) in predicting the biological behavior of meningioma. Material and methods The study included 30 cases of meningioma, 15 (50%) recurrent and 15 (50%) non-recurrent. The immunohistochemical expression of PR was studied. Cell kinetic using the Ki67/MIB-1 labelling index (LI) was evaluated and correlated to PR expression. Results PR expression was significantly more common in benign meningioma (BM) than atypical meningioma (AM) and malignant meningioma (MM). The mean Ki-67/MIB-1 LI was significantly highest in MM, high in AM and lowest in BM. In PR-negative meningioma, the mean Ki-67/MIB-1 LI was significantly higher compared with PR-positive meningioma. In the recurrent group, PR was frequently immunonegative and the mean Ki-67/MIB-1 LI was higher than that in the non-recurrent group. The difference in PR expression between non-recurrent and recurrent cases was significant only in BM. The difference in Ki-67/ MIB-1 LI was significant only when recurrent meningioma was compared with non-recurrent tumor, irrespective of the grade. Conclusion BM expresses PR more than AM and MM. The absence of this expression in BM implies a likely risk for recurrence. Ki-67/MIB-1 LI is valuable to predict tumor grade and the overall risk of recurrence. However, it must be interpreted with caution in BM.