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Agopiantz M, Carnot M, Denis C, Martin E, Gauchotte G. Hormone Receptor Expression in Meningiomas: A Systematic Review. Cancers (Basel) 2023; 15:cancers15030980. [PMID: 36765937 PMCID: PMC9913299 DOI: 10.3390/cancers15030980] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/05/2023] Open
Abstract
Meningiomas are, in most cases, low grade intracranial tumors. However, relapses are frequent. To date, only a few prognostic markers are described in the literature. Several studies have discussed the expression of progesterone, estrogen, androgen, and somatostatin receptors. The utility of analyzing these expressions for prognostic, theragnostic, and therapeutic purposes remains unclear. The aim of this study was to report the expression of these receptors, based on immunohistochemistry. Cochrane Collaboration guidelines and PRISMA statements were followed. We did an online search in PubMed using the MeSH database. References were selected if the investigations occurred from 1990 to 2022. 61 references were included (34 descriptive observational studies, 26 analytical observational studies, and one case report). In this review, we describe the expression of these receptors in function of age, sex, hormonal context, localization, histological subtype, grade, and recurrence.
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Affiliation(s)
- Mikaël Agopiantz
- Department of Assisted Reproductive Technologies, CHRU de Nancy, 54000 Nancy, France
- Faculty of Medicine of Nancy, Université de Lorraine, INSERM UMRS 1256, Nutrition, Genetics and Environmental Risk Exposure (NGERE), 54000 Nancy, France
| | - Mélanie Carnot
- Department of Medical Gynecology, CHRU de Nancy, Université de Lorraine, 54000 Nancy, France
| | - Constance Denis
- Department of Medical Gynecology, CHRU de Nancy, Université de Lorraine, 54000 Nancy, France
| | - Elena Martin
- Department of Medical Gynecology, CHRU de Nancy, Université de Lorraine, 54000 Nancy, France
| | - Guillaume Gauchotte
- Faculty of Medicine of Nancy, Université de Lorraine, INSERM UMRS 1256, Nutrition, Genetics and Environmental Risk Exposure (NGERE), 54000 Nancy, France
- Department of Biopathology CHRU-ICL, CHRU de Nancy, 54500 Vandoeuvre-lès-Nancy, France
- Correspondence: ; Tel.: +33-3-83-65-60-17
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Spinal Meningioma Surgery through the Ages-Single-Center Experience over Three Decades. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58111549. [PMID: 36363510 PMCID: PMC9698896 DOI: 10.3390/medicina58111549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/07/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2022]
Abstract
Background and Objectives: Spinal meningiomas, which are well characterized and are most frequently intradural extramedullary tumors, represent 25% of all intradural spinal tumors. The goal of this study was to compare the outcomes of surgically treated patients with spinal meningiomas in two time intervals with special emphasis on postoperative functional outcomes. Methods: Patients with spinal meningiomas admitted to our department between 1990 and 2020 were enrolled and divided into a historic cohort (HC; treated 1990−2007) and a current cohort (CC; treated 2008−2020). Patients’ clinical data and surgical and radiological reports were retrospectively analyzed up to 5 years. Preoperative and postoperative neurological function were assessed using the modified McCormick Scale (mMCS). The Charlson Comorbidity Index (CCI) was used to evaluate the effect of comorbidities on the preoperative status and postoperative outcome. Results: We included 300 patients. Participants in the CC (n = 144) were significantly younger compared to those in the HC (n = 156), with twice as many patients <50 years of age (p < 0.001). The most common tumor location was the thoracic spine (n = 204). The median follow-up was 38.1 months (±30.3 standard deviation). A symptom duration until surgery <12 months was significantly associated with an earlier improvement in the mMCS (p = 0.045). In the CC, this duration was shorter and patients’ neurological function at the first and last follow-ups was significantly better than for those in the HC (p < 0.001 for both). Conclusions: Our study results suggested that the impact of surgical management and postoperative rehabilitation on spinal meningioma patients’ long-term neurological outcome has reached important milestones over the last decades. An earlier diagnosis led to earlier surgical treatment and improved patients’ postoperative neurological recovery. Our results exposed that surgical therapy for spinal meningioma should be performed within 12 months after appearance of symptoms to achieve a better recovery.
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Wu S, Zhang X, Rui W, Sheng Y, Yu Y, Zhang Y, Yao Z, Qiu T, Ren Y. A nomogram strategy for identifying the subclassification of IDH mutation and ATRX expression loss in lower-grade gliomas. Eur Radiol 2022; 32:3187-3198. [PMID: 35133485 DOI: 10.1007/s00330-021-08444-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/22/2021] [Accepted: 10/25/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To construct a radiomics nomogram based on multiparametric MRI data for predicting isocitrate dehydrogenase 1 mutation (IDH +) and loss of nuclear alpha thalassemia/mental retardation syndrome X-linked expression (ATRX -) in patients with lower-grade gliomas (LrGG; World Health Organization [WHO] 2016 grades II and III). METHODS A total of 111 LrGG patients (76 mutated IDH and 35 wild-type IDH) were enrolled, divided into a training set (n = 78) and a validation set (n = 33) for predicting IDH mutation. IDH + LrGG patients were further stratified into the ATRX - (n = 38) and ATRX + (n = 38) subtypes. A total of 250 radiomics features were extracted from the region of interest of each tumor, including that from T2 fluid-attenuated inversion recovery (T2 FLAIR), contrast-enhanced T1 WI, ASL-derived cerebral blood flow (CBF), DWI-derived ADC, and exponential ADC (eADC). A radiomics signature was selected using the Elastic Net regression model, and a radiomics nomogram was finally constructed using the age, gender information, and above features. RESULTS The radiomics nomogram identified LrGG patients for IDH mutation (C-index: training sets = 0.881, validation sets = 0.900) and ATRX loss (C-index: training sets = 0.863, validation sets = 0.840) with good calibration. Decision curve analysis further confirmed the clinical usefulness of the two nomograms for predicting IDH and ATRX status. CONCLUSIONS The nomogram incorporating age, gender, and the radiomics signature provided a clinically useful approach in noninvasively predicting IDH and ATRX mutation status for LrGG patients. The proposed method could facilitate MRI-based clinical decision-making for the LrGG patients. KEY POINTS • Non-invasive determination of IDH and ATRX gene status of LrGG patients can be obtained with a radiomics nomogram. • The proposed nomogram is constructed by radiomics signature selected from 250 radiomics features, combined with age and gender. • The proposed radiomics nomogram exhibited good calibration and discrimination for IDH and ATRX gene mutation stratification of LrGG patients in both training and validation sets.
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Affiliation(s)
- Shiman Wu
- Department of Radiology, Huashan Hospital, Fudan University, Jing'an District, 12 Middle Urumqi Road, Shanghai, 200040, People's Republic of China
| | - Xi Zhang
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Wenting Rui
- Department of Radiology, Huashan Hospital, Fudan University, Jing'an District, 12 Middle Urumqi Road, Shanghai, 200040, People's Republic of China
| | - Yaru Sheng
- Department of Radiology, Huashan Hospital, Fudan University, Jing'an District, 12 Middle Urumqi Road, Shanghai, 200040, People's Republic of China
| | - Yang Yu
- Department of Radiology, Huashan Hospital, Fudan University, Jing'an District, 12 Middle Urumqi Road, Shanghai, 200040, People's Republic of China
| | - Yong Zhang
- GE Healthcare, Shanghai, People's Republic of China
| | - Zhenwei Yao
- Department of Radiology, Huashan Hospital, Fudan University, Jing'an District, 12 Middle Urumqi Road, Shanghai, 200040, People's Republic of China
| | - Tianming Qiu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Jing'an District, 12 Middle Urumqi Road, Shanghai, 200040, People's Republic of China.
| | - Yan Ren
- Department of Radiology, Huashan Hospital, Fudan University, Jing'an District, 12 Middle Urumqi Road, Shanghai, 200040, People's Republic of China.
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Leclair NK, Lambert WA, Wu Q, Wolansky L, Becker K, Li L, Leishangthem L, Bulsara KR. Genomic sequencing of a pregnancy associated symptomatic meningioma of the diaphragma sellae: a case report. Br J Neurosurg 2022:1-5. [PMID: 35001774 DOI: 10.1080/02688697.2021.2024503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/29/2021] [Accepted: 12/27/2021] [Indexed: 11/02/2022]
Abstract
Pregnancy-associated meningiomas have unique considerations and features regarding their pathophysiology, location, genetic profile, and neurosurgical management. These tumours have been reported to undergo rapid growth during gestation and regression post-partum, implicating a role for female sex hormones in tumour physiology. In addition, these tumours occur at a higher incidence in the skull base compared to sporadic meningiomas in the general population, often impinging neurovascular structures and requiring emergent resection. While the genomics of sporadic meningiomas have been described, there are no reports characterizing the genetic features of those associated with pregnancy. Here we describe a patient diagnosed with a diphragma sellae meningioma early in the third trimester after presenting with rapidly deteriorating vision. At 32 weeks gestation the baby was delivered by caesarean section and the tumour subsequently removed. Genomic profiling of the tumour sample revealed variants of unknown significant (VUS) in six genes, none of which were in canonical meningioma drivers. We describe our surgical approach and discuss the relevant pathology and genomics, as well as medical and surgical management considerations of meningiomas in pregnancy.
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Affiliation(s)
- Nathan K Leclair
- School of Medicine, University of Connecticut, Farmington, CT, USA
| | | | - Qian Wu
- Department of Pathology and Laboratory Medicine, UConn Health, Farmington, CT, USA
| | - Leo Wolansky
- Department of Radiology, UConn Health, Farmington, CT, USA
| | - Kevin Becker
- Department of Oncology, UConn Health, Farmington, CT, USA
| | - Lei Li
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | | | - Ketan R Bulsara
- Division of Neurosurgery, Department of Surgery, UConn Health, Farmington, CT, USA
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