Hormone Receptor Status and KI67 Proliferation Index in Meningiomas
Keywords:
Hormone receptors, Progesterone receptor, Ki67 proliferation index, Atypical meningioma
Abstract
Background: Meningiomas are the most common extra-axial tumours of central nervous system arising from arachnoidal cap cells. The biological behaviour of these tumours is unpredictable because of the tendency of these tumours to recur irrespective of the grade. However, WHO grading is the most useful morphological predictor of recurrence. Additional prognostic parameters like Ki67 proliferation index and progesterone receptor status are useful in predicting the risk of recurrence. This study was undertaken to evaluate the spectrum of Ki67 proliferation index in various grades of meningiomas and to correlate these findings with the hormone receptor status. Methods: In this study 225 cases of meningiomas, over 6 yrs period, were studied which included grade 1 and grade 2 meningiomas. The relation between Grade, Ki67 proliferation index and progesterone receptor status was studied. Result: We found a significant positive correlation between grade and Ki67 proliferation index at 0.01 level and significant negative correlation between Grade and progesterone receptor status at 0.05 level. There was also significant negative correlation between progesterone receptor status and Ki67 proliferation index in cases with progesterone receptor staining score of 6 to 12. Many of the grade 1 meningiomas also showed a higher Ki67 proliferation index Conclusion: In this study we conclude that, PR and Ki67 Proliferation index are useful supplements of routine histopathological assessment of meningiomas and can be used as prognostic indicators regarding behavior and response to treatment.References
1. Roser F, Nakamura M, Bellinzona M, Rosahl SK, Ostertag H, Samii M. The prognostic value of progesterone receptor status in meningiomas. J Clin Pathol 2004; 57: 1033-7.
2. Brandis A, Mirzai S, Tatagiba M, Walter GF, Samii M, Ostertag H. Immunohistochemical detection of female sex hormone receptors in meningiomas: correlation with clinical and histological features. Neurosurgery 1993; 33: 212-7.
3. Cahill DW, Bashirelahi N, Solomon LW, Dalton T, Salcman M, Ducker TB. Estrogen and Progesterone receptors in meningiomas. J Neurosurg 1984; 60:985-93.
4. Shanthi V, Grandhi B, Rao NM, Rao BS, Reddy VM. Assessing the Prognostic Importance of ER, PR Expression in Meningiomas by Comparing with Proliferative Rate Using Ki67. Indian Journal of Pathology: Research and Practice 2017; 6:431-4.
5. Gursan N, Gundogdu C, Albayrak A, Kabalar ME. Immunohistochemical detection of progesterone receptors and the correlation with Ki-67 labeling indices in paraffin-embedded sections of meningiomas. Int J Neurosci 2002;112:463-70.
6. Strik HM, Strobelt I, Pietsch-Breitfeld B, Iglesias-Rozas JR, Will B, Meyermann R. The impact of progesterone receptor expression on relapse in the long-term clinical course of 93 benign meningiomas. In Vivo 2002;16:265-70.
7. Blankenstein MA, Verheijen FM, Jacobs JM, Donker TH, van Duijnhoven MW, Thijssen JH. Occurrence, regulation, and significance of progesterone receptors in human meningioma. Steroids 2000;65:795-800.
8. Fewings PE, Battersby RD, Timperley WR. Long-term follow up of progesterone receptor status in benign meningioma: a prognostic indicator of recurrence? J Neurosurg 2000;92:401-5.
9. Nagashima G, Aoyagi M, Wakimoto H, Tamaki M, Ohno K, Hirakawa K. Immunohistochemical detection of progesterone receptors and the correlation with Ki-67 labeling indices in paraffin-embedded sections of meningiomas. Neurosurgery 1995;37:478-82.
10. Perrot-Applanat M, Groyer-Picard MT, Kujas M. Immunocytochemical study of progesterone receptor in human meningioma. Acta Neurochir 1992;115:20-30.
11. Markwalder TM, Gerber HA, Waelti E, Schaffner T, Markwalder RV. Hormonotherapy of meningiomas with medroxyprogesterone acetate: Immunohistochemical demonstration of the effect of medroxyprogesterone acetate on growth fractions of meningioma cells using the monoclonal antibody Ki-67. Surg Neurol 1988;30:97-101.
12. Halper J, Colvard DS, Scheithauer BW, Jiang NS, Press MF, Graham ML 2nd et al. Estrogen and progesterone receptors in meningiomas: Comparison of nuclear binding, dextran-coated charcoal, and immunoperoxi-dase staining assays. Neurosurgery 1989;25:546-53.
13. Khalid H. Immunohistochemical study of estrogen receptor related antigen, progesterone, and estrogen receptors in human intracranial meningiomas. Cancer 1994;74:679-85.
14. Hsu DW, Efird JT, Tessa Hedley-Whyte E. Progesterone and estrogen receptors in meningiomas. Prognostic considerations. J Neurosurg 1997;86:113-20.
15. Markwalder TM, Zava DT, Goldhirsch A, Markwalder RV. Estrogen and progesterone receptors in meningiomas in relation to clinical and pathologic features. Surg Neurol 1983;20:42-7.
16. Blaauw G, Blankenstein MA, Lamberts SW. Sex steroid receptors in human meningiomas. Acta Neurochir 1986;79:42-7.
17. Hayward E, Whitwell H, Paul KS, Barnes DM. Steroid receptors in human meningiomas. Clin Neuropharmacol 1984;7:351-6.
18. Ironside JW, Battersby RDE, Dangerfield VJM, Parsons MA, Timperley WR, JCE Underwood. Cryostat section assasy of estrogen and progesterone receptors in meningiomas: A clinicopathological study. J Clin Pathol 1986;39:44-50.
19. Matsuda Y, Kawamoto K, Kiya K, Kurisu K, Sugiyama K, Uozumi T. Antitumor effects of antiprogesterones on human meningioma cells in vitro and in vivo. J Neurosurg 1994;80:527-34.
20. Whittle IR, Foo MS, Besser M, Vanderfield GK. Progesterone and estrogen receptors in meningiomas: Biochemical and clinicopathological considerations. Aust N Z J Surg 1984;54;325-30.
21. Horsfall DJ, Goldsmith KG, Ricciardelli C, Skinner JM, Tilley WD, Marshall VR. Steroid hormone and epidermal growth factor receptors in meningiomas. Aust N Z J Surg 1989;59:881-88.
22. Schlegel J, Ullrich B, Stumm G, Gass P. Expression of the cerb B-2-encoded oncoprotein and progesterone receptor in human meningiomas. Acta Neuropathol 1993;86:473-79.
23. Carroll RS, Glowacka D, Dashner K, Black PM. Progesterone receptor expression in meningiomas. Cancer Res 1993;53:1312-6.
24. Schrell UM, Adams EF, Fahlbusch R, Greb R, Jirikowski G, Prior R et al. Hormonal dependency of cerebral meningiomas. Part 1: Female sex steroid receptors and thier significance as specific markers for adjuvant medical therapy. J Neurosurg 1990;73:743-9.
25. Olson JJ. Laboratory evidence for the hormonal dependency of meningiomas. Human Reprod 1994; 9:195-201.
26. Lesch KP, Gross S. Estrogen receptor immunoreactivity in meningiomas. Comparison with the binding activity of estrogen, progesterone and androgen receptors. J Neurosurg 1987;67:237-43.
27. Schwartz MR, Randolph RL, Cech DA, Rose JE, Panko WB. Steroid hormone binding macromolecules in meningiomas failure to meet criteria of specific receptors. Cancer 1984;53:922-7.
28. Maiuri F, De Caro MB, Esposito F, Cappabianca P, Strazzullo V, Pettinato G et al. Recurrences of meningiomas: predictive value of pathological features and hormonal and growth factors. J Neurooncol 2007;82:63-8.
29. Whittle IR, Foo MS, Besser M, Vanderfield GK. Progesterone and oestrogen receptors in meningiomas: biochemical and clinicopathological considerations. Aust N Z J Surg 1984;54:325-30.
30. Wolfsberger S, Doostkam S, Boecher-Schwarz HG,Roessler K, van Trotsenburg M, Hainfellner JA et al. Progesterone-receptor index in meningiomas: correlation with clinico-pathological parameters and review of the literature. Neurosurg Rev 2004;27:238-45.
31. Yamasaki F, Yoshioka H, Hama S, Sugiyama K, Arita K, Kurisu K. Recurrence of meningiomas. Cancer 2000; 89: 1102-10.
32. Walter LM, Rogers PA, Girling JE. The role of progesterone in endometrial angiogenesis in pregnant and ovariectomised mice. Reproduction 2005; 29:765-7.
33. Taghipour M, Rakei SM, Monabati A, Nahavandi- Nejad M. The role of estrogen and progesterone receptors in grading of the malignancy of meningioma. Iranian Red Crescent Medical journal 2007; 9:17-21.
34. Wahab M, Al-Azzawi F. Meningioma and hormonal influences. Climacteric 2003; 6:285-92
35. Dutta V, Malik A, Topgay T, Deb P. Immunohistochemical Study Characterizing Estrogen and Progesterone Receptors Status in Meningiomas and Correlation with MIB-1 Labeling index. Indian Journal of Pathology: Research and Practice 2012; 1:61-6.
2. Brandis A, Mirzai S, Tatagiba M, Walter GF, Samii M, Ostertag H. Immunohistochemical detection of female sex hormone receptors in meningiomas: correlation with clinical and histological features. Neurosurgery 1993; 33: 212-7.
3. Cahill DW, Bashirelahi N, Solomon LW, Dalton T, Salcman M, Ducker TB. Estrogen and Progesterone receptors in meningiomas. J Neurosurg 1984; 60:985-93.
4. Shanthi V, Grandhi B, Rao NM, Rao BS, Reddy VM. Assessing the Prognostic Importance of ER, PR Expression in Meningiomas by Comparing with Proliferative Rate Using Ki67. Indian Journal of Pathology: Research and Practice 2017; 6:431-4.
5. Gursan N, Gundogdu C, Albayrak A, Kabalar ME. Immunohistochemical detection of progesterone receptors and the correlation with Ki-67 labeling indices in paraffin-embedded sections of meningiomas. Int J Neurosci 2002;112:463-70.
6. Strik HM, Strobelt I, Pietsch-Breitfeld B, Iglesias-Rozas JR, Will B, Meyermann R. The impact of progesterone receptor expression on relapse in the long-term clinical course of 93 benign meningiomas. In Vivo 2002;16:265-70.
7. Blankenstein MA, Verheijen FM, Jacobs JM, Donker TH, van Duijnhoven MW, Thijssen JH. Occurrence, regulation, and significance of progesterone receptors in human meningioma. Steroids 2000;65:795-800.
8. Fewings PE, Battersby RD, Timperley WR. Long-term follow up of progesterone receptor status in benign meningioma: a prognostic indicator of recurrence? J Neurosurg 2000;92:401-5.
9. Nagashima G, Aoyagi M, Wakimoto H, Tamaki M, Ohno K, Hirakawa K. Immunohistochemical detection of progesterone receptors and the correlation with Ki-67 labeling indices in paraffin-embedded sections of meningiomas. Neurosurgery 1995;37:478-82.
10. Perrot-Applanat M, Groyer-Picard MT, Kujas M. Immunocytochemical study of progesterone receptor in human meningioma. Acta Neurochir 1992;115:20-30.
11. Markwalder TM, Gerber HA, Waelti E, Schaffner T, Markwalder RV. Hormonotherapy of meningiomas with medroxyprogesterone acetate: Immunohistochemical demonstration of the effect of medroxyprogesterone acetate on growth fractions of meningioma cells using the monoclonal antibody Ki-67. Surg Neurol 1988;30:97-101.
12. Halper J, Colvard DS, Scheithauer BW, Jiang NS, Press MF, Graham ML 2nd et al. Estrogen and progesterone receptors in meningiomas: Comparison of nuclear binding, dextran-coated charcoal, and immunoperoxi-dase staining assays. Neurosurgery 1989;25:546-53.
13. Khalid H. Immunohistochemical study of estrogen receptor related antigen, progesterone, and estrogen receptors in human intracranial meningiomas. Cancer 1994;74:679-85.
14. Hsu DW, Efird JT, Tessa Hedley-Whyte E. Progesterone and estrogen receptors in meningiomas. Prognostic considerations. J Neurosurg 1997;86:113-20.
15. Markwalder TM, Zava DT, Goldhirsch A, Markwalder RV. Estrogen and progesterone receptors in meningiomas in relation to clinical and pathologic features. Surg Neurol 1983;20:42-7.
16. Blaauw G, Blankenstein MA, Lamberts SW. Sex steroid receptors in human meningiomas. Acta Neurochir 1986;79:42-7.
17. Hayward E, Whitwell H, Paul KS, Barnes DM. Steroid receptors in human meningiomas. Clin Neuropharmacol 1984;7:351-6.
18. Ironside JW, Battersby RDE, Dangerfield VJM, Parsons MA, Timperley WR, JCE Underwood. Cryostat section assasy of estrogen and progesterone receptors in meningiomas: A clinicopathological study. J Clin Pathol 1986;39:44-50.
19. Matsuda Y, Kawamoto K, Kiya K, Kurisu K, Sugiyama K, Uozumi T. Antitumor effects of antiprogesterones on human meningioma cells in vitro and in vivo. J Neurosurg 1994;80:527-34.
20. Whittle IR, Foo MS, Besser M, Vanderfield GK. Progesterone and estrogen receptors in meningiomas: Biochemical and clinicopathological considerations. Aust N Z J Surg 1984;54;325-30.
21. Horsfall DJ, Goldsmith KG, Ricciardelli C, Skinner JM, Tilley WD, Marshall VR. Steroid hormone and epidermal growth factor receptors in meningiomas. Aust N Z J Surg 1989;59:881-88.
22. Schlegel J, Ullrich B, Stumm G, Gass P. Expression of the cerb B-2-encoded oncoprotein and progesterone receptor in human meningiomas. Acta Neuropathol 1993;86:473-79.
23. Carroll RS, Glowacka D, Dashner K, Black PM. Progesterone receptor expression in meningiomas. Cancer Res 1993;53:1312-6.
24. Schrell UM, Adams EF, Fahlbusch R, Greb R, Jirikowski G, Prior R et al. Hormonal dependency of cerebral meningiomas. Part 1: Female sex steroid receptors and thier significance as specific markers for adjuvant medical therapy. J Neurosurg 1990;73:743-9.
25. Olson JJ. Laboratory evidence for the hormonal dependency of meningiomas. Human Reprod 1994; 9:195-201.
26. Lesch KP, Gross S. Estrogen receptor immunoreactivity in meningiomas. Comparison with the binding activity of estrogen, progesterone and androgen receptors. J Neurosurg 1987;67:237-43.
27. Schwartz MR, Randolph RL, Cech DA, Rose JE, Panko WB. Steroid hormone binding macromolecules in meningiomas failure to meet criteria of specific receptors. Cancer 1984;53:922-7.
28. Maiuri F, De Caro MB, Esposito F, Cappabianca P, Strazzullo V, Pettinato G et al. Recurrences of meningiomas: predictive value of pathological features and hormonal and growth factors. J Neurooncol 2007;82:63-8.
29. Whittle IR, Foo MS, Besser M, Vanderfield GK. Progesterone and oestrogen receptors in meningiomas: biochemical and clinicopathological considerations. Aust N Z J Surg 1984;54:325-30.
30. Wolfsberger S, Doostkam S, Boecher-Schwarz HG,Roessler K, van Trotsenburg M, Hainfellner JA et al. Progesterone-receptor index in meningiomas: correlation with clinico-pathological parameters and review of the literature. Neurosurg Rev 2004;27:238-45.
31. Yamasaki F, Yoshioka H, Hama S, Sugiyama K, Arita K, Kurisu K. Recurrence of meningiomas. Cancer 2000; 89: 1102-10.
32. Walter LM, Rogers PA, Girling JE. The role of progesterone in endometrial angiogenesis in pregnant and ovariectomised mice. Reproduction 2005; 29:765-7.
33. Taghipour M, Rakei SM, Monabati A, Nahavandi- Nejad M. The role of estrogen and progesterone receptors in grading of the malignancy of meningioma. Iranian Red Crescent Medical journal 2007; 9:17-21.
34. Wahab M, Al-Azzawi F. Meningioma and hormonal influences. Climacteric 2003; 6:285-92
35. Dutta V, Malik A, Topgay T, Deb P. Immunohistochemical Study Characterizing Estrogen and Progesterone Receptors Status in Meningiomas and Correlation with MIB-1 Labeling index. Indian Journal of Pathology: Research and Practice 2012; 1:61-6.
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2020-03-12
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