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Aung TM, Ngamjarus C, Proungvitaya T, Saengboonmee C, Proungvitaya S. Biomarkers for prognosis of meningioma patients: A systematic review and meta-analysis. PLoS One 2024; 19:e0303337. [PMID: 38758750 PMCID: PMC11101050 DOI: 10.1371/journal.pone.0303337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 04/23/2024] [Indexed: 05/19/2024] Open
Abstract
Meningioma is the most common primary brain tumor and many studies have evaluated numerous biomarkers for their prognostic value, often with inconsistent results. Currently, no reliable biomarkers are available to predict the survival, recurrence, and progression of meningioma patients in clinical practice. This study aims to evaluate the prognostic value of immunohistochemistry-based (IHC) biomarkers of meningioma patients. A systematic literature search was conducted up to November 2023 on PubMed, CENTRAL, CINAHL Plus, and Scopus databases. Two authors independently reviewed the identified relevant studies, extracted data, and assessed the risk of bias of the studies included. Meta-analyses were performed with the hazard ratio (HR) and 95% confidence interval (CI) of overall survival (OS), recurrence-free survival (RFS), and progression-free survival (PFS). The risk of bias in the included studies was evaluated using the Quality in Prognosis Studies (QUIPS) tool. A total of 100 studies with 16,745 patients were included in this review. As the promising markers to predict OS of meningioma patients, Ki-67/MIB-1 (HR = 1.03, 95%CI 1.02 to 1.05) was identified to associate with poor prognosis of the patients. Overexpression of cyclin A (HR = 4.91, 95%CI 1.38 to 17.44), topoisomerase II α (TOP2A) (HR = 4.90, 95%CI 2.96 to 8.12), p53 (HR = 2.40, 95%CI 1.73 to 3.34), vascular endothelial growth factor (VEGF) (HR = 1.61, 95%CI 1.36 to 1.90), and Ki-67 (HR = 1.33, 95%CI 1.21 to 1.46), were identified also as unfavorable prognostic biomarkers for poor RFS of meningioma patients. Conversely, positive progesterone receptor (PR) and p21 staining were associated with longer RFS and are considered biomarkers of favorable prognosis of meningioma patients (HR = 0.60, 95% CI 0.41 to 0.88 and HR = 1.89, 95%CI 1.11 to 3.20). Additionally, high expression of Ki-67 was identified as a prognosis biomarker for poor PFS of meningioma patients (HR = 1.02, 95%CI 1.00 to 1.04). Although only in single studies, KPNA2, CDK6, Cox-2, MCM7 and PCNA are proposed as additional markers with high expression that are related with poor prognosis of meningioma patients. In conclusion, the results of the meta-analysis demonstrated that PR, cyclin A, TOP2A, p21, p53, VEGF and Ki-67 are either positively or negatively associated with survival of meningioma patients and might be useful biomarkers to assess the prognosis.
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Affiliation(s)
- Tin May Aung
- Centre of Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Chetta Ngamjarus
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Tanakorn Proungvitaya
- Centre of Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Charupong Saengboonmee
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
| | - Siriporn Proungvitaya
- Centre of Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand
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Ibrahim A, Toss MS, Makhlouf S, Miligy IM, Minhas F, Rakha EA. Improving mitotic cell counting accuracy and efficiency using phosphohistone-H3 (PHH3) antibody counterstained with haematoxylin and eosin as part of breast cancer grading. Histopathology 2023; 82:393-406. [PMID: 36349500 PMCID: PMC10100421 DOI: 10.1111/his.14837] [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: 08/09/2022] [Revised: 10/08/2022] [Accepted: 11/05/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Mitotic count in breast cancer is an important prognostic marker. Unfortunately, substantial inter- and intraobserver variation exists when pathologists manually count mitotic figures. To alleviate this problem, we developed a new technique incorporating both haematoxylin and eosin (H&E) and phosphorylated histone H3 (PHH3), a marker highly specific to mitotic figures, and compared it to visual scoring of mitotic figures using H&E only. METHODS Two full-face sections from 97 cases were cut, one stained with H&E only, and the other was stained with PHH3 and counterstained with H&E (PHH3-H&E). Counting mitoses using PHH3-H&E was compared to traditional mitoses scoring using H&E in terms of reproducibility, scoring time, and the ability to detect mitosis hotspots. We assessed the agreement between manual and image analysis-assisted scoring of mitotic figures using H&E and PHH3-H&E-stained cells. The diagnostic performance of PHH3 in detecting mitotic figures in terms of sensitivity and specificity was measured. Finally, PHH3 replaced the mitosis score in a multivariate analysis to assess its significance. RESULTS Pathologists detected significantly higher mitotic figures using the PHH3-H&E (median ± SD, 20 ± 33) compared with H&E alone (median ± SD, 16 ± 25), P < 0.001. The concordance between pathologists in identifying mitotic figures was highest when using the dual PHH3-H&E technique; in addition, it highlighted mitotic figures at low power, allowing better agreement on choosing the hotspot area (k = 0.842) in comparison with standard H&E (k = 0.625). A better agreement between image analysis-assisted software and the human eye was observed for PHH3-stained mitotic figures. When the mitosis score was replaced with PHH3 in a Cox regression model with other grade components, PHH3 was an independent predictor of survival (hazard ratio [HR] 5.66, 95% confidence interval [CI] 1.92-16.69; P = 0.002), and even showed a more significant association with breast cancer-specific survival (BCSS) than mitosis (HR 3.63, 95% CI 1.49-8.86; P = 0.005) and Ki67 (P = 0.27). CONCLUSION Using PHH3-H&E-stained slides can reliably be used in routine scoring of mitotic figures and integrating both techniques will compensate for each other's limitations and improve diagnostic accuracy, quality, and precision.
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Affiliation(s)
- Asmaa Ibrahim
- Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham Biodiscovery Institute, University Park, Nottingham, UK.,Histopathology department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Michael S Toss
- Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham Biodiscovery Institute, University Park, Nottingham, UK
| | - Shorouk Makhlouf
- Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham Biodiscovery Institute, University Park, Nottingham, UK.,Department of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Islam M Miligy
- Histopathology department, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt.,Histopathology department, School of Medicine, University of Nottingham, Nottingham, UK
| | - Fayyaz Minhas
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Emad A Rakha
- Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham Biodiscovery Institute, University Park, Nottingham, UK.,Histopathology department, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt.,Histopathology department, School of Medicine, University of Nottingham, Nottingham, UK
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Maier AD. Malignant meningioma. APMIS 2022; 130 Suppl 145:1-58. [DOI: 10.1111/apm.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Andrea Daniela Maier
- Department of Neurosurgery, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
- Department of Pathology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
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Prat-Acín R, Guarín-Corredor MJ, Galeano-Senabre I, Ayuso-Sacido A, Vera-Sempere F. Value of KI-67/MIB-1 labeling index and simpson grading system to predict the recurrence of who grade I intracranial meningiomas compared to who grade II. J Clin Neurosci 2021; 86:32-37. [PMID: 33775343 DOI: 10.1016/j.jocn.2021.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/30/2020] [Accepted: 01/08/2021] [Indexed: 12/21/2022]
Abstract
Simpson grading of resection has been used as a predictor of intracranial meningioma (IM) recurrence. Histopathological findings, like the Ki-67/MIB-1 labeling index, may be useful in the assessment risk of recurrence. Our objective was to analyze the predictive value of meningioma recurrence using both parameters. We retrospectively studied 322 consecutive patients with histopathological diagnosis of IM WHO grade I and 43 patients with IM WHO grade II in a 13-year period. Multivariate survival analysis was performed. In the WHO grade I IM group, recurrence was observed in 28 patients (8.69%). The Cox regression model for WHO grade I IM, provided a significative hazard ratio (HR) for Ki-67/MIB-1 index ≥3 (HR = 36.35, p < 0.001) and Simpson's grading resection, grade II (HR = 2.03, p = 0.045), grade III (HR = 3.41, p = 0.034) and grade IV (HR = 19.75, p ≥ 0.001). In the WHO grade II IM group, recurrence was observed in 10 patients (23.25%). The Cox regression model for WHO grade II IM, provided a significative hazard ratio (HR) for Ki-67/MIB-1 index ≥3% (HR = 1.66, p < 0.001) and Simpson's grading resection grade III (HR = 3.96, p = 0.027). The Kaplan-Meier survival curve showed a similar distribution of survival between WHO grade I IM with Ki-67/MIB-1 ≥3% and WHO grade II IM. In WHO grade I meningiomas, the Ki-67/MIB-1 index and Simpson grading were both independent predictors of recurrence. A similar management protocol should be advisable for WHO grade I with Ki-67/MIB-1 ≥3% and WHO grade II meningiomas.
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Affiliation(s)
- Ricardo Prat-Acín
- Neurosurgery Department. Hospital Universitario y Politécnico La Fe, Valencia, Spain; Nanomedicine and Sensors Unit, Hospital Universitario y Politécnico La Fe, Universidad Politécnica de Valencia, Spain.
| | | | - Inma Galeano-Senabre
- Neurosurgery Department. Hospital Universitario y Politécnico La Fe, Valencia, Spain; Nanomedicine and Sensors Unit, Hospital Universitario y Politécnico La Fe, Universidad Politécnica de Valencia, Spain
| | - Angel Ayuso-Sacido
- Brain Tumour Laboratory, Fundación Vithas, Grupo Hospitales Vithas, Madrid, Spain; Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Madrid, Spain
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Daniela Maier A, Brøchner CB, Bartek Jr. J, Eriksson F, Ugleholdt H, Broholm H, Mathiesen T. Mitotic and Proliferative Indices in WHO Grade III Meningioma. Cancers (Basel) 2020; 12:cancers12113351. [PMID: 33198268 PMCID: PMC7697885 DOI: 10.3390/cancers12113351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/06/2020] [Accepted: 11/10/2020] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Malignant meningiomas are rare primary intracranial tumors associated with considerable morbidity and mortality. The diagnosis is based on the number of mitotic figures (mitotic index, MI). Consequently, the quantification of mitotic figures is prone to inter- and intraobserver variability. The mitotic marker, phosphohistone-H3 (PHH3), has been shown to be a more robust mitotic marker. Despite the prognostic value of MI across all meningioma grades, little is known of the prognostic value of the MI within malignant meningioma. Therefore, this study investigates the MI in a series of malignant meningiomas to analyze the association to progression-free survival and mitotic and proliferative indices. Furthermore, we investigated the precision (repeatability) of mitotic counts and the agreement between MI and PHH3 MI. Abstract Meningiomas with inherently high mitotic indices and poor prognosis, such as WHO grade III meningiomas, have not been investigated separately to establish interchangeability between conventional mitotic index counted on H&E stained slides (MI) and mitotic index counted on phosphohistone-H3 stained slides (PHH3 MI). This study investigates the agreement of MI and PHH3 MI and to analyze the association of progression-free survival (PFS) and MI, PHH3 MI, and the proliferative index (PI, Ki-67) in WHO grade III meningioma. Tumor specimens from 24 consecutive patients were analyzed for expression of Ki-67, PHH3 MI, and MI. Quantification was performed independently by two observers who made replicate counts in hot spots and overall tumor staining. Repeatability in replicate counts from MI and PHH3 MI was low in both observers. Consequently, we could not report the agreement. MI, PHH3 MI and hot spot counts of Ki-67 were associated with PFS (MI hot spot HR = 1.61, 95% CI 1.12–2.31, p = 0.010; PHH3 MI hot spot HR = 1.59, 95% CI 1.15–2.21, p = 0.006; Ki-67 hot spot HR = 1.06, 95% CI 1.02–1.11. p = 0.004). We found markedly low repeatability of manually counted MI and PHH3 MI in WHO grade III meningioma, and we could not conclude that the two methods agreed. Subsequently, quantification with better repeatability should be sought. All three biomarkers were associated with PFS.
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Affiliation(s)
- Andrea Daniela Maier
- Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 6, 2100 Copenhagen, Denmark; (J.B.J.); (T.M.)
- Pathology Department, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 7, 2100 Copenhagen, Denmark; (C.B.B.); (H.U.); (H.B.)
- Correspondence: ; Tel.: +45-25825824
| | - Christian Beltoft Brøchner
- Pathology Department, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 7, 2100 Copenhagen, Denmark; (C.B.B.); (H.U.); (H.B.)
| | - Jiri Bartek Jr.
- Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 6, 2100 Copenhagen, Denmark; (J.B.J.); (T.M.)
- Department of Neurosurgery, Karolinska University Hospital, Solnavägen 1, Solna, 17176 Stockholm, Sweden
- Department of Clinical Neuroscience and Department of Medicine, Karolinska Institutet, Solnavägen 1, Solna, 17176 Stockholm, Sweden
| | - Frank Eriksson
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark;
| | - Heidi Ugleholdt
- Pathology Department, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 7, 2100 Copenhagen, Denmark; (C.B.B.); (H.U.); (H.B.)
| | - Helle Broholm
- Pathology Department, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 7, 2100 Copenhagen, Denmark; (C.B.B.); (H.U.); (H.B.)
| | - Tiit Mathiesen
- Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 6, 2100 Copenhagen, Denmark; (J.B.J.); (T.M.)
- Department of Clinical Neuroscience and Department of Medicine, Karolinska Institutet, Solnavägen 1, Solna, 17176 Stockholm, Sweden
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2100 Copenhagen, Denmark
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Gill V, Leibman N, Monette S, Craft DM, Bergman PJ. Prognostic Indicators and Clinical Outcome in Dogs with Subcutaneous Mast Cell Tumors Treated with Surgery Alone: 43 Cases. J Am Anim Hosp Assoc 2020; 56:215-225. [PMID: 32412337 DOI: 10.5326/jaaha-ms-6960] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this study was to determine if clinical findings, histologic grade, or other histologic features were associated with clinical outcome in dogs with subcutaneous mast cell tumors (MCTs). Medical records of 43 client-owned dogs were retrospectively reviewed, and follow-up information was gathered via phone or follow-up examination. Progression-free survival (PFS), disease-free interval (DFI), and overall survival were calculated. Forty-two and twenty-two dogs, respectively, had grade 2 (Patnaik grading system) or low-grade tumors (two-tier grading system). Median PFS was 1474 days. Median DFI was not reached at >1968 days. Overall median survival time was not reached at >1968 days. In univariate analysis, argyrophilic nucleolar organizer regions (AgNORs), proliferating cell nuclear antigen, and mitotic index were negatively prognostic for PFS whereas Ki-67, proliferating cell nuclear antigen, and microvessel density were negatively prognostic for DFI. In multivariate analysis, AgNORs remained negatively prognostic for PFS. Results suggest that proliferation indices, especially AgNORs, may be useful in predicting the rare poor outcomes in dogs with subcutaneous MCTs. The vast majority of subcutaneous MCTs appear to be low or intermediate grade with excellent outcomes from good local tumor control.
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Affiliation(s)
- Virginia Gill
- From Maine Veterinary Medical Center, Scarborough, Maine (V.G.); Department of Oncology (N.L.) and Flaherty Comparative Oncology Laboratory (D.M.C.), The Animal Medical Center, New York, New York; Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, The Rockefeller University, Weill Cornell Medicine, New York, New York (S.M.); and Katonah Bedford Veterinary Center, Bedford Hills, New York (P.J.B.)
| | - Nicole Leibman
- From Maine Veterinary Medical Center, Scarborough, Maine (V.G.); Department of Oncology (N.L.) and Flaherty Comparative Oncology Laboratory (D.M.C.), The Animal Medical Center, New York, New York; Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, The Rockefeller University, Weill Cornell Medicine, New York, New York (S.M.); and Katonah Bedford Veterinary Center, Bedford Hills, New York (P.J.B.)
| | - Sebastien Monette
- From Maine Veterinary Medical Center, Scarborough, Maine (V.G.); Department of Oncology (N.L.) and Flaherty Comparative Oncology Laboratory (D.M.C.), The Animal Medical Center, New York, New York; Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, The Rockefeller University, Weill Cornell Medicine, New York, New York (S.M.); and Katonah Bedford Veterinary Center, Bedford Hills, New York (P.J.B.)
| | - Diane M Craft
- From Maine Veterinary Medical Center, Scarborough, Maine (V.G.); Department of Oncology (N.L.) and Flaherty Comparative Oncology Laboratory (D.M.C.), The Animal Medical Center, New York, New York; Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, The Rockefeller University, Weill Cornell Medicine, New York, New York (S.M.); and Katonah Bedford Veterinary Center, Bedford Hills, New York (P.J.B.)
| | - Philip J Bergman
- From Maine Veterinary Medical Center, Scarborough, Maine (V.G.); Department of Oncology (N.L.) and Flaherty Comparative Oncology Laboratory (D.M.C.), The Animal Medical Center, New York, New York; Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, The Rockefeller University, Weill Cornell Medicine, New York, New York (S.M.); and Katonah Bedford Veterinary Center, Bedford Hills, New York (P.J.B.)
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Liu N, Song SY, Jiang JB, Wang TJ, Yan CX. The prognostic role of Ki-67/MIB-1 in meningioma: A systematic review with meta-analysis. Medicine (Baltimore) 2020; 99:e18644. [PMID: 32118704 PMCID: PMC7478528 DOI: 10.1097/md.0000000000018644] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Ki-67 is a typical immunohistochemical marker for cell proliferation. Higher expression of Ki-67 is correlated with poor clinical outcomes in several cancers. However, the prognostic value of Ki-67 on the prognosis of meningiomas is still controversial. The purpose of this meta-analysis was to evaluate the prognostic value of Ki-67 in meningiomas. METHODS AND MATERIALS We searched Medline and EMBASE from inception to December 31, 2018, to identify relevant articles. Using a fixed or random effects model, pooled hazard ratios (HRs) for overall survival (OS) and disease/progression/recurrence-free survival (D/P/RFS) were estimated. RESULTS A total of 43 studies, comprising 5012 patients, were included in this analysis. Higher Ki-67 expression levels were significantly associated with worse OS (HR = 1.565; 95% CI: 1.217-2.013) and D/P/RFS (HR = 2.644; 95% CI: 2.264-3.087) in meningiomas. Subgroup analysis revealed that all the included factors (ethnicity, tumor grade, HR sources, definition of cutoffs, cutoff values) for heterogeneity investigation can affect the pooled results. Among them, the definitions of cutoffs and cutoff values factor are the two main contributors toward heterogeneity. Multivariable meta-regression analysis also showed that methodologies used for cutoff value definition contributed to the high inner-study heterogeneity. CONCLUSIONS Higher Ki-67 expression levels negatively influenced survival in meningiomas. A higher cutoff value (>4%) is more appropriate for prognosis prediction. It is highly recommended that Ki-67 expression profile could be assessed in meningiomas treatment for predicting survival. And patients with elevated expression of Ki-67 need to have close follow-ups.
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Affiliation(s)
- Ning Liu
- Department of Neurosurgery, Sanbo Brain Hospital
| | - Si-Ying Song
- Department of Neurology, Xuanwu Hospital, Capital Medical University
| | - Jia-Bao Jiang
- Department of Basic Medicine, Fuzhou Medical College, Nanchang University
| | - Ting-Jian Wang
- Department of Neurosurgery, the First Affiliated Hospital of Nanchang University, China
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Low Expression of Phosphatase and Tensin Homolog and High Expression of Ki-67 as Risk Factors of Prognosis in Cranial Meningiomas. World Neurosurg 2019; 136:e196-e203. [PMID: 31887465 DOI: 10.1016/j.wneu.2019.12.108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the expression characteristics, correlations with clinical factors, and prognostic values of phosphatase and tensin homolog (PTEN) and Ki-67 in cranial meningiomas. METHODS The expression of PTEN and Ki-67 at the mRNA level was analyzed in 34 frozen meningiomas. Clinical data collection, follow-up, correlations, and survival analyses were performed. RESULTS Twenty-two men and 12 women were included in the study, with a median age of 52.72 ± 11.72 years on admission. The average expression levels of PTEN and Ki-67 were 2.71 ± 1.73 and 0.50 ± 0.57, respectively. The World Health Organization grade III meningiomas exhibited significantly lower levels of PTEN (P = 0.037), whereas grade I meningiomas expressed significantly lower levels of Ki-67 (P = 0.001). For recurrent lesions, the mean Ki-67 expression level was 0.97 ± 0.76, which was significantly greater than that of primary meningiomas with a mean value of 0.25 ± 0.13 (P < 0.001). The Ki-67 expression level was positively correlated with the tumor volume (P < 0.01) and negatively correlated with preoperative Karnofsky Performance Status scale (KPS, P < 0.01), postoperative KPS (P < 0.05), and follow-up KPS (P < 0.01). However, the PTEN expression level did not correlate with these variables. Based on the multivariate Cox analysis, Ki-67 expression level (P < 0.001, hazard ratio [HR] 8.16, 95% confidence interval [CI] 2.86-23.29), and PTEN expression level (P = 0.018, HR 0.47, 95% CI 0.25-0.88) were independent prognostic factors for tumor recurrence. Ki-67 (P = 0.001, HR 19.73, 95% CI 3.65-106.61) and PTEN expression levels (P = 0.024, HR 0.36, 95% CI 0.15-0.88) were also independent prognostic factors for mortality. CONCLUSIONS A low PTEN expression and a high Ki-67 expression could predict malignancy in cranial meningiomas.
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Pham DT, Skaland I, Winther TL, Salvesen Ø, Torp SH. Correlation Between Digital and Manual Determinations of Ki-67/MIB-1 Proliferative Indices in Human Meningiomas. Int J Surg Pathol 2019; 28:273-279. [PMID: 31771372 DOI: 10.1177/1066896919889148] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Objective. Proliferative activity in tumor tissues is assessed as the percentage of Ki-67/MIB-1-positive cells, or the proliferative index (PI). The PI is routinely assessed manually. However, the subjectivity of manual assessments might result in poor reproducibility. We hypothesized that digital assessments might reduce the error. Method. In our study, we assessed Ki-67/MIB-1 PIs, both manually and digitally, with tissue microarrays constructed from 141 human meningioma samples. Spearman-rank correlation and κ statistics were applied for correlation and agreement analyses, respectively. Mann-Whitney U tests were used to compare MIB-1 PIs between groups. Prognostic ability was assessed with Kaplan-Meier and Cox regression analyses. Results. We found a significant, high correlation (Spearman ρ = 0.832, P < .01) and moderate agreement (κ coefficient = 0.617, observed agreement = 80.9%) between the 2 methods. Both methods found significantly different Ki-67/MIB-1 PIs for different World Health Organization grades (P < .05). Neither method showed significant prognostic value. Conclusion. Digital determinations of Ki-67/MIB-1 PIs in human meningiomas are feasible for the daily routine.
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Affiliation(s)
- Duc-Tien Pham
- NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Ivar Skaland
- Stavanger University Hospital, Stavanger, Norway
| | - Theo L Winther
- NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Øyvind Salvesen
- NTNU-Norwegian University of Science and Technology, Trondheim, Norway
| | - Sverre H Torp
- NTNU-Norwegian University of Science and Technology, Trondheim, Norway.,St. Olavs University Hospital, Trondheim, Norway
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Khieu ML, Broadwater DR, Aden JK, Coviello JM, Lynch DT, Hall JM. The Utility of Phosphohistone H3 (PHH3) in Follicular Lymphoma Grading: A Comparative Study With Ki-67 and H&E Mitotic Count. Am J Clin Pathol 2019; 151:542-550. [PMID: 30788495 DOI: 10.1093/ajcp/aqz003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To determine the utility of phosphohistone H3 (PHH3) mitotic count (MC) in grading follicular lymphoma (FL). METHODS FL cases were identified (2005-2017). Three hematopathologists recorded their average Ki-67 proliferation index, MC/high-power field (hpf) using PHH3 and H&E stains, and number of centroblasts/hpf. Results were assessed for correlations and interobserver variability. RESULTS Forty-three cases of FL were studied. PHH3 MC resulted in the strongest correlation to grade (r = 0.701, P < .0001) compared with Ki-67 proliferation index (PI) (r = 0.681, P < .0001) and H&E MC (r = 0.536, P = .0002) and the strongest linear relationship to centroblast count (R2 = 0.453). Agreement among pathologists was strongest for PHH3 (intraclass correlation coefficient [ICC] = 0.86) followed by Ki-67 PI (ICC = 0.85) and H&E MC (ICC = 0.78). CONCLUSIONS PHH3 correlates best to histologic grade and has less interobserver variability compared with Ki-67 PI and H&E MC. These results support using PHH3 as an adjunct in FL grading.
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Affiliation(s)
- Michelle L Khieu
- Department of Pathology, Brooke Army Medical Center, San Antonio, TX
| | | | - James K Aden
- Department of Pathology, Brooke Army Medical Center, San Antonio, TX
| | - Jean M Coviello
- Department of Pathology, Brooke Army Medical Center, San Antonio, TX
| | - David T Lynch
- Department of Pathology, Brooke Army Medical Center, San Antonio, TX
| | - Jordan M Hall
- Department of Pathology, Brooke Army Medical Center, San Antonio, TX
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Maier AD, Bartek J, Eriksson F, Ugleholdt H, Juhler M, Broholm H, Mathiesen TI. Clinical and histopathological predictors of outcome in malignant meningioma. Neurosurg Rev 2019; 43:643-653. [DOI: 10.1007/s10143-019-01093-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/10/2019] [Accepted: 03/03/2019] [Indexed: 02/01/2023]
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12
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The correlation between phosphorylated Histone H3 (PHH3) and p-STAT3 in Meningiomas. Clin Neurol Neurosurg 2019; 178:46-50. [DOI: 10.1016/j.clineuro.2019.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/19/2018] [Accepted: 01/24/2019] [Indexed: 12/26/2022]
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13
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Puri M, Hoover SB, Hewitt SM, Wei BR, Adissu HA, Halsey CHC, Beck J, Bradley C, Cramer SD, Durham AC, Esplin DG, Frank C, Lyle LT, McGill LD, Sánchez MD, Schaffer PA, Traslavina RP, Buza E, Yang HH, Lee MP, Dwyer JE, Simpson RM. Automated Computational Detection, Quantitation, and Mapping of Mitosis in Whole-Slide Images for Clinically Actionable Surgical Pathology Decision Support. J Pathol Inform 2019; 10:4. [PMID: 30915258 PMCID: PMC6396430 DOI: 10.4103/jpi.jpi_59_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 11/27/2018] [Indexed: 12/25/2022] Open
Abstract
Background Determining mitotic index by counting mitotic figures (MFs) microscopically from tumor areas with most abundant MF (hotspots [HS]) produces a prognostically useful tumor grading biomarker. However, interobserver concordance identifying MF and HS can be poorly reproducible. Immunolabeling MF, coupled with computer-automated counting by image analysis, can improve reproducibility. A computational system for obtaining MF values across digitized whole-slide images (WSIs) was sought that would minimize impact of artifacts, generate values clinically relatable to counting ten high-power microscopic fields of view typical in conventional microscopy, and that would reproducibly map HS topography. Materials and Methods Relatively low-resolution WSI scans (0.50 μm/pixel) were imported in grid-tile format for feature-based MF segmentation, from naturally occurring canine melanomas providing a wide range of proliferative activity. MF feature extraction conformed to anti-phospho-histone H3-immunolabeled mitotic (M) phase cells. Computer vision image processing was established to subtract key artifacts, obtain MF counts, and employ rotationally invariant feature extraction to map MF topography. Results The automated topometric HS (TMHS) algorithm identified mitotic HS and mapped select tissue tiles with greatest MF counts back onto WSI thumbnail images to plot HS topographically. Influence of dye, pigment, and extraneous structure artifacts was minimized. TMHS diagnostic decision support included image overlay graphics of HS topography, as well as a spreadsheet and plot of tile-based MF count values. TMHS performance was validated examining both mitotic HS counting and mapping functions. Significantly correlated TMHS MF mapping and metrics were demonstrated using repeat analysis with WSI in different orientation (R 2 = 0.9916) and by agreement with a pathologist (R 2 = 0.8605) as well as through assessment of counting function using an independently tuned object counting algorithm (OCA) (R 2 = 0.9482). Limits of agreement analysis support method interchangeability. MF counts obtained led to accurate patient survival prediction in all (n = 30) except one case. By contrast, more variable performance was documented when several pathologists examined similar cases using microscopy (pair-wise correlations, rho range = 0.7597-0.9286). Conclusions Automated TMHS MF segmentation and feature engineering performance were interchangeable with both observer and OCA in digital mode. Moreover, enhanced HS location accuracy and superior method reproducibility were achieved using the automated TMHS algorithm compared to the current practice employing clinical microscopy.
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Affiliation(s)
- Munish Puri
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Shelley B Hoover
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Stephen M Hewitt
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, MD, USA
| | - Bih-Rong Wei
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.,Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, MD, USA
| | - Hibret Amare Adissu
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Charles H C Halsey
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Jessica Beck
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Charles Bradley
- Department of Pathobiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Sarah D Cramer
- Cancer and Inflammation Program, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Amy C Durham
- Department of Pathobiology, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Chad Frank
- Department of Microbiology, Immunology, and Pathology, Veterinary Diagnostic Laboratory, Colorado State University, Fort Collins, CO, USA
| | - L Tiffany Lyle
- Women's Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | | | - Melissa D Sánchez
- Department of Pathobiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Paula A Schaffer
- Department of Microbiology, Immunology, and Pathology, Veterinary Diagnostic Laboratory, Colorado State University, Fort Collins, CO, USA
| | - Ryan P Traslavina
- Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Elizabeth Buza
- Department of Pathobiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Howard H Yang
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Maxwell P Lee
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Jennifer E Dwyer
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - R Mark Simpson
- Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
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14
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Phosphorylated Histone H3 (PHH3) as a Novel Cell Proliferation Marker and Prognosticator for Meningeal Tumors: A Short Review. Appl Immunohistochem Mol Morphol 2018; 26:627-631. [DOI: 10.1097/pai.0000000000000499] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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15
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Phosphohistone H3 (PHH3) as a surrogate of mitotic figure count for grading in meningiomas: a comparison of PHH3 (S10) versus PHH3 (S28) antibodies. Virchows Arch 2018; 474:87-96. [DOI: 10.1007/s00428-018-2458-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/14/2018] [Accepted: 09/17/2018] [Indexed: 02/01/2023]
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16
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Baeesa SS, Hussein D, Altalhy A, Bakhaidar MG, Alghamdi FA, Bangash M, Abuzenadah A. Malignant Transformation and Spine Metastasis of an Intracranial Grade I Meningioma: In Situ Immunofluorescence Analysis of Cancer Stem Cells Case Report and Literature Review. World Neurosurg 2018; 120:274-289. [PMID: 30205223 DOI: 10.1016/j.wneu.2018.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/31/2018] [Accepted: 09/02/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Malignant meningiomas are rare neoplasms of the central nervous system that occur de novo or rarely as a result of transformation. They have a higher rate of recurrence and metastasis accompanied by a significantly shorter survivorship compared with benign variants. Meningioma cancer stem cells (CSCs) have been previously shown to be associated with resistance and aggressiveness. However, the role they play in meningioma progression is still being investigated. CASE DESCRIPTION We report a 29-year-old man who underwent a resection of a grade I meningioma in 2011. The patient had multiple local recurrences of the tumor that showed an aggressive change in behavior and transformation to grade III meningioma, and developed extracranial metastasis to the cervical spine. He underwent multiple operations and received radiotherapy. Analysis of the tissues indicated the presence of CSC markers before metastasis, and showed increased expressions of associated markers in the metastasized tissue. In addition, similar to the patient's profile, the pharmacological testing of a primary cell line retrieved from the metastasized tissues showed a high level of drug tolerance and a diminished ability to initiate apoptosis. CONCLUSIONS Malignant progression of grade I meningioma can occur, and its eventuality may be anticipated by detecting CSCs. We performed a comprehensive literature review of relevant cases and discussed the clinical, diagnostic, and management characteristics of the reported cases.
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Affiliation(s)
- Saleh S Baeesa
- Division of Neurosurgery, Department of Surgery, King Abdulaziz University Hospital, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Deema Hussein
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ali Altalhy
- Division of Neurosurgery, Department of Surgery, King Abdulaziz University Hospital, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohamad G Bakhaidar
- Division of Neurosurgery, Department of Surgery, King Abdulaziz University Hospital, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fahad A Alghamdi
- Department of Pathology, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Bangash
- Division of Neurosurgery, Department of Surgery, King Abdulaziz University Hospital, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Adel Abuzenadah
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Center for Innovation for Personalized Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
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17
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Hao Q, Dai C, Deng Y, Xu P, Tian T, Lin S, Wang M, Liu K, Song D, Wu Y, Guo Y, Dai Z. Pooling analysis on prognostic value of PHH3 expression in cancer patients. Cancer Manag Res 2018; 10:2279-2288. [PMID: 30104898 PMCID: PMC6071623 DOI: 10.2147/cmar.s167569] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background Various studies have evaluated the significance of phosphohistone-H3 (PHH3) expression in cancer patients, but controversy over its reliability remains. We conducted a meta-analysis to summarize the prognostic relevance of PHH3 expression in cancer patients. Patients and methods Nineteen studies, including 4803 patients, were identified by searching PubMed, Web of Science, Embase, and Cochrane Library. The correlation of PHH3 expression level with overall survival (OS), disease-free survival, and recurrence-free survival was analyzed. Results Overall, the results suggest that high expression of PHH3 can predict a poor OS (HR=2.66, 95% CI=1.74–4.08, P<0.001), disease-free survival (HR=3.40, 95% CI=1.47–7.87, P=0.004), and recurrence-free survival (HR=2.80, 95% CI=1.61–4.85, P<0.001) in cancer patients. The subgroup analysis showed that highly expressed PHH3 was significantly related to breast cancer (HR=5.66, 95% CI=2.72–11.78, P<0.001) and urogenital tumors (HR=3.01, 95% CI=1.78–5.09, P<0.001). Furthermore, no significant difference was found between Asian (HR=1.98, 95% CI=1.08–3.63, P=0.026) and Caucasian populations (HR=3.01, 95% CI=1.87–4.85, P<0.001) regarding OS and PHH3 expression. Conclusion This meta-analysis indicates that high expression of PHH3 may serve as a biomarker for poor prognosis in patients with cancer.
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Affiliation(s)
- Qian Hao
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China,
| | - Cong Dai
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China,
| | - Yujiao Deng
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China,
| | - Peng Xu
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China,
| | - Tian Tian
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China,
| | - Shuai Lin
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China,
| | - Meng Wang
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China,
| | - Kang Liu
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China,
| | - Dingli Song
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China,
| | - Ying Wu
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China,
| | - Yan Guo
- School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, People's Republic of China,
| | - Zhijun Dai
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China,
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Lewitowicz P, Matykiewicz J, Chrapek M, Koziel D, Horecka-Lewitowicz A, Gluszek-Osuch M, Wawrzycka I, Gluszek S. Tumor Digital Masking Allows Precise Patient Triaging: A Study Based on Ki-67 Scoring in Gastrointestinal Stromal Tumors. SCANNING 2018; 2018:7807416. [PMID: 30245762 PMCID: PMC6139189 DOI: 10.1155/2018/7807416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/28/2018] [Accepted: 08/05/2018] [Indexed: 05/13/2023]
Abstract
BACKGROUND Technological advances constantly provide cutting-edge tools that enhance the progress of diagnostic capabilities. Gastrointestinal stromal tumors belong to a family of mesenchymal tumors where patient triaging is still based on traditional criteria such as mitotic count, tumor size, and tumor location. Limitations of the human eye and randomness in choice of area for mitotic figure counting compel us to seek more objective solutions such as digital image analysis. Presently, the labelling of proliferative activity is becoming a routine task amidst many cancers. The purpose of the present study was to compare the traditional method of prediction based on mitotic ratio with digital image analysis of cell cycle-dependent proteins. METHODS Fifty-seven eligible cases were enrolled. Furthermore, a digital analysis of previously performed whole tissue section immunohistochemical assays was executed. Digital labelling covered both hotspots and not-hotspots equally. RESULTS We noted a significant diversity of proliferative activities, and consequently, the results pointed to 6.5% of Ki-67, counted in hotspots, as the optimal cut-off for low-high-grade GIST. ROC analysis (AUC = 0.913; 95% CI: 0.828-0.997, p < 0.00001) and odds ratio (OR = 40.0, 95% CI: 6.7-237.3, p < 0.0001) pointed to Ki-67 16% as the cut-off for very high-grade (groups 5-6) cases. With help of a tumor digital map, we revealed possible errors resulting from a wrong choice of field for analysis. We confirmed that Ki-67 scores are in line with the level of intracellular metabolism that could be used as the additional biomarker. CONCLUSIONS Tumor digital masking is very promising solution for repeatable and objective labelling. Software adjustments of nuclear shape, outlines, size, etc. are helpful to omit other Ki-67-positive cells especially small lymphocytes. Our results pointed to Ki-67 as a good biomarker in GIST, but concurrently, we noted significant differences in used digital approaches which could lead to unequivocal results.
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Affiliation(s)
- Piotr Lewitowicz
- Department of Pathology, Faculty of Medicine and Health Sciences, Jan Kochanowski University in Kielce, Kielce, Poland
| | - Jaroslaw Matykiewicz
- Department of Surgery and Surgical Nursing, Faculty of Medicine and Health Sciences, Jan Kochanowski University in Kielce, Kielce, Poland
- Department of General, Oncological and Endocrine Surgery, The Voivodship Hospital in Kielce, Kielce, Poland
| | - Magdalena Chrapek
- Department of Probability Theory and Statistics, Institute of Mathematics, The Faculty of Mathematics and Natural Sciences, Jan Kochanowski University in Kielce, Kielce, Poland
| | - Dorota Koziel
- Department of Surgery and Surgical Nursing, Faculty of Medicine and Health Sciences, Jan Kochanowski University in Kielce, Kielce, Poland
| | - Agata Horecka-Lewitowicz
- Department of Public Health, Faculty of Medicine and Heath Sciences, Jan Kochanowski University in Kielce, Kielce, Poland
| | - Martyna Gluszek-Osuch
- Department of Public Health, Faculty of Medicine and Heath Sciences, Jan Kochanowski University in Kielce, Kielce, Poland
| | - Iwona Wawrzycka
- Department of Surgery and Surgical Nursing, Faculty of Medicine and Health Sciences, Jan Kochanowski University in Kielce, Kielce, Poland
- Department of General, Oncological and Endocrine Surgery, The Voivodship Hospital in Kielce, Kielce, Poland
| | - Stanisław Gluszek
- Department of Surgery and Surgical Nursing, Faculty of Medicine and Health Sciences, Jan Kochanowski University in Kielce, Kielce, Poland
- Department of General, Oncological and Endocrine Surgery, The Voivodship Hospital in Kielce, Kielce, Poland
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Winther TL, Torp SH. The anti-apoptotic protein survivin can improve the prognostication of meningioma patients. PLoS One 2017; 12:e0185217. [PMID: 28953948 PMCID: PMC5617184 DOI: 10.1371/journal.pone.0185217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/10/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The 2016 WHO histopathological grading includes a substantial within-variation in recurrence risk, and is thus insufficient to predict prognosis after initial surgery of patients suffering from meningiomas. The aim of this study was to compare the prognostic value of the histopathological grading and the conventional biomarker MIB-1 with expression of the anti-apoptotic protein survivin to see if this biomarker could complement recurrence prediction. METHODS Using immunohistochemistry, the expression of MIB-1 and survivin were determined as labeling indices (LIs) in tissue micro arrays from 160 human meningiomas. The accuracy of prognostication was assessed with receiver operator characteristics analyses and standard survival analyses. RESULTS The expression of survivin was significantly associated with both histopathological grade (P = 0.022) and recurrence status (P = 0.035). A survivin LI of 1% was identified as the optimal cutoff value to predict recurrence (P = 0.003), and was proven as more reliable than the histopathological grading (P = 0.497) and MIB-1 expression (P = 0.091). This result was further strengthened in multivariate analyses where survivin expression was revealed as an independent predictor of recurrence-free survival, while the histopathological grading and MIB-1 expression did not reach significance (P ≥ 0.156). CONCLUSIONS These findings suggest that incorporation of survivin in the clinical practice might be useful as complement for the histopathological grading and should further be evaluated in independent prospective studies.
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Affiliation(s)
- Theo L. Winther
- Departments of Laboratory Medicine, Children’s and Women’s Health, University of Science and Technology, Trondheim, Norway
- * E-mail:
| | - Sverre H. Torp
- Departments of Laboratory Medicine, Children’s and Women’s Health, University of Science and Technology, Trondheim, Norway
- Pathology and Medical genetics, St. Olavs Hospital, Trondheim, Norway
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