Abstract
Meningiomas are frequent central nervous system tumors. Although most meningiomas are benign (WHO grade I) and curable by surgery, WHO grade II and III tumors remain therapeutically challenging due to frequent recurrence. Interestingly, relapse also occurs in some WHO grade I meningiomas. Hence, we investigated the transcriptional features defining aggressive (recurrent, malignantly progressing or WHO grade III) meningiomas in 144 cases. Meningiomas were categorized into non-recurrent (NR), recurrent (R), and tumors undergoing malignant progression (M) in addition to their WHO grade. Unsupervised transcriptomic analysis in 62 meningiomas revealed transcriptional profiles lining up according to WHO grade and clinical subgroup. Notably aggressive subgroups (R+M tumors and WHO grade III) shared a large set of differentially expressed genes (n=332; p<0.01, FC>1.25). In an independent multicenter validation set (n=82), differential expression of 10 genes between WHO grades was confirmed. Additionally, among WHO grade I tumors differential expression between NR and aggressive R+M tumors was affirmed for PTTG1, AURKB, ECT2, UBE2C and PRC1, while MN1 and LEPR discriminated between NR and R+M WHO grade II tumors. Univariate survival analysis revealed a significant association with progression-free survival for PTTG1, LEPR, MN1, ECT2, PRC1, COX10, UBE2C expression, while multivariate analysis identified a prediction for PTTG1 and LEPR mRNA expression independent of gender, WHO grade and extent of resection. Finally, stainings of PTTG1 and LEPR confirmed malignancy-associated protein expression changes. In conclusion, based on the so far largest study sample of WHO grade III and recurrent meningiomas we report a comprehensive transcriptional landscape and two prognostic markers.
Highlights
Meningiomas are common brain tumors accounting for approximately 36 % of all primary central nervous system tumors [1]
Employing principal component analysis (PCA), we observed a spectrum of transcriptional profiles lining up according to the WHO grade as well as to the clinical subgroup (i.e. NR, non-recurrent; R, recurrent without malignant progression; M, malignant progression) in principal component 1 (PC1) (Supplementary Figure S2)
In search for new biomarkers and putative drug targets of clinically aggressive meningiomas, we performed a comprehensive analysis of the transcriptomic landscape in a large, multicenter study sample consisting of 144 meningiomas WHO°I to °III
Summary
Meningiomas are common brain tumors accounting for approximately 36 % of all primary central nervous system tumors [1]. We performed intersection studies between 1NR tumors and aggressive (recurrent, malignantly progressing or WHO grade III) meningiomas (1M+R, 2M+R and WHO°III).
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