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Torp SH, Arnli MB, Scheie D. Clinicopathological significance of concurrent ErbB receptor expression in human meningioma. Mol Clin Oncol 2023; 19:79. [PMID: 37719042 PMCID: PMC10502797 DOI: 10.3892/mco.2023.2675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/17/2023] [Indexed: 09/19/2023] Open
Abstract
In general, human meningiomas grow slowly and have a favourable prognosis; however, some are prone to recur despite their benign histology. Therefore, knowledge of their tumour biology is essential to determine objective biomarkers that can identify cases with an increased risk for recurrence and to generate effective treatment options. Thus, studies on the epidermal growth factor receptor (EGFR) family, comprising ErbB1/EGFR, ErbB2/HER2, ErbB3/HER3 and ErbB4/HER4, are important. We have recently published papers on the expression of each of these receptor proteins in human meningiomas. The present study aimed to assess the clinicopathological significance of their concurrent expression. A total of 185 grade 1 and 2 meningiomas with robust clinical data underwent immunohistochemical analyses with antibodies against the aforementioned receptors. All meningiomas exhibited upregulation of these receptor proteins relative to normal meninges. In addition, the expression of phosphorylated/activated ErbB1/EGFR1 and phosphorylated/activated ErbB2/HER2 was significantly associated with histological malignancy grade and prognosis, respectively. The concurrent upregulation of ErbB receptors in human meningioma supports their fundamental role in the tumourigenesis of these tumours, and they could thus be exploited in diagnostics, prognosis, and ultimately, in targeted clinical interventions.
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Affiliation(s)
- Sverre Helge Torp
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
- Department of Pathology, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
| | | | - David Scheie
- Department of Pathology, Copenhagen University Hospital, DK-2100 Copenhagen, Denmark
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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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Somatostatin Receptors in Human Meningiomas-Clinicopathological Aspects. Cancers (Basel) 2021; 13:cancers13225704. [PMID: 34830858 PMCID: PMC8616360 DOI: 10.3390/cancers13225704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 11/09/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Meningioma diagnostics and grading are currently based on subjective histopathological criteria given by the 2016 World Health Organization (WHO) classification. However, biomarkers may provide a more objective approach to diagnostics. This study was designed to elucidate the diagnostic and prognostic value of somatostatin receptors (SSTRs) as biomarkers in meningiomas, which could help to identify patients with a higher risk of recurrence and provide more personalized treatment. We have confirmed, in a population of 162 patients, that SSTRs have diagnostic value and may aid in the differentiation between WHO grade 1 and grade 2 tumors. Furthermore, SSTR1, SSTR2 and SSTR5 were associated with higher malignancy grades. SSTR2 expression was found to be characteristic in meningiomas. To maintain objectiveness, we scoped for a digital evaluation of immunoreactivity. We aim to impact and motivate researchers to further investigations towards more objective criteria in meningioma diagnostics, which in turn will improve patient care. Abstract Meningiomas have high recurrence rates despite frequently benign histopathological appearances. Somatostatin receptors (SSTRs) may be reliable biomarkers that could identify patients with increased risk of recurrence. Even though SSTRs are previously detected in meningiomas, their associations to clinicopathological features remain unclear. The aim of this study was to investigate the diagnostic and prognostic value of SSTRs in a large series of human meningiomas with long follow-up data. Immunohistochemistry was used to measure the expression of SSTR1-SSTR5 in tissue samples from 162 patients diagnosed with intracranial meningiomas of World Health Organization (WHO) grade 1 or 2. Digital scoring and a manual staining index were applied to assess immunoreactivity. All SSTRs, except SSTR4, were upregulated in our series of meningiomas. SSTR1 (p = 0.036), SSTR2 (p = 0.036) and SSTR5 (p = 0.029) were associated with a higher malignancy grade. SSTR2 presented as the most reliable marker. Only SSTR2 was associated with time to recurrence (TTR) in univariate Cox regression analyses. Manual staining index was strongly correlated with digital scoring for all SSTRs (r > 0.65, p < 0.001). SSTRs, and especially SSTR2, are useful in the diagnostics of meningiomas, even though their prognostic value appears limited. Digital scoring is valuable to ensure reproducibility.
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Receptor Tyrosine Kinases as Candidate Prognostic Biomarkers and Therapeutic Targets in Meningioma. Int J Mol Sci 2021; 22:ijms222111352. [PMID: 34768783 PMCID: PMC8583503 DOI: 10.3390/ijms222111352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/07/2021] [Accepted: 10/09/2021] [Indexed: 11/17/2022] Open
Abstract
Meningioma (MGM) is the most common type of intracranial tumor in adults. The validation of novel prognostic biomarkers to better inform tumor stratification and clinical prognosis is urgently needed. Many molecular and cellular alterations have been described in MGM tumors over the past few years, providing a rational basis for the identification of biomarkers and therapeutic targets. The role of receptor tyrosine kinases (RTKs) as oncogenes, including those of the ErbB family of receptors, has been well established in several cancer types. Here, we review histological, molecular, and clinical evidence suggesting that RTKs, including the epidermal growth factor receptor (EGFR, ErbB1), as well as other members of the ErbB family, may be useful as biomarkers and therapeutic targets in MGM.
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Merrill SA, Sharma A, Carlin RE, McCullough AE, Porter AB, Bendok BR, Kouloumberis PE. A Rare Intracranial Collision Tumor of Meningioma and Metastatic Uterine Adenocarcinoma: Case Report and Literature Review. World Neurosurg 2020; 145:340-347. [PMID: 32987172 DOI: 10.1016/j.wneu.2020.09.108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/18/2020] [Accepted: 09/19/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND A collision tumor is a rare entity consisting of 2 histologically distinct tumor types (benign or malignant) in the same anatomic location. This can occur from a tumor-to-tumor metastasis or as a result of 2 adjacent intracranial tumors colliding and growing together. To our knowledge, this is the first reported case of collision tumor with confirmed meningioma and uterine adenocarcinoma. Multiple mechanisms have been proposed for the facilitative growth of collision tumors, including local epigenetic signaling. Clinically, it is important to consider collision tumors in the differential diagnosis of a rapidly growing intracranial lesion in the setting of systemic cancer to provide optimal surgical and postoperative management. CASE DESCRIPTION A 78-year-old, right-handed woman with a known 10-year history of stable meningioma presented for evaluation of a right sphenoid wing lesion. She had recently completed treatment of uterine papillary serous carcinoma with no evidence of disease on follow-up imaging. On presentation, there was significant progression of the meningioma resulting in brain compression and right third nerve palsy. The patient underwent urgent resection of the lesion. Pathology demonstrated a collision tumor with a combination of metastatic uterine papillary serous carcinoma and meningioma. CONCLUSIONS It is important to consider a collision tumor when a patient with a benign intracranial lesion presents with rapid progression, even in the context of a systemic cancer that rarely metastasizes to the brain. Appropriate histopathologic assessment is crucial in these cases and can have a significant impact on treatment plan and prognosis.
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Affiliation(s)
- Sarah A Merrill
- Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA
| | | | | | | | - Alyx B Porter
- Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA
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de Carvalho GTC, da Silva-Martins WC, de Magalhães KCSF, Nunes CB, Soares AN, Tafuri LSDA, Simões RT. Recurrence/Regrowth in Grade I Meningioma: How to Predict? Front Oncol 2020; 10:1144. [PMID: 32903787 PMCID: PMC7438949 DOI: 10.3389/fonc.2020.01144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 06/08/2020] [Indexed: 11/22/2022] Open
Abstract
The HLA-G and HLA-E molecules, Ki67, progesterone (PR), estrogen (ER) and androgen receptors (AR), p53, COX-2, and HER2 were studied to assess whether the biological behavior of grade I meningiomas is related to their expression. Tissue samples from 96 patients with grade I intracranial meningiomas were analyzed by immunohistochemistry on tissue microarray blocks (TMA) using antibodies specific for HLA-G, HLA-E, Ki67, PR, ER, AR, p53, COX-2, and HER2. Meningiomas were classified as small (≤2 cm, 1.0%), medium (>2 and ≤4 cm, 32.3%), and large (>4 cm, 66.7%). Tumor size was not related to recurrence/regrowth (p = 0.486), but was significantly correlated with peritumoral edema (p = 0.031) and intratumoral calcifications (p = 0.018). Recurrent meningiomas were observed in 14.6% of cases. Immunostaining for each marker was: HLA-G 100%; HLA-E 95.6%; PR 62%; ER 2.1%; AR 6.5%; p53 92.6%; COX-2 100%; HER2 0%; Ki67, mean 2.61 ± 2.29%, median 2.1%. Primary and recurrent meningiomas showed no significant relation with HLA-E and hormone receptors (p > 0.05), except for Ki67, where a higher median was observed in recurrent tumors than in primary (p = 0.014). The larger the tumor, the more severe the peritumoral edema, and the greater the presence of calcifications. Ki67 appears to be a good biomarker of recurrence/regrowth in grade I meningiomas.
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Affiliation(s)
- Gervásio Teles Cardoso de Carvalho
- Laboratory of Molecular Biology and Biomarkers, Santa Casa de Belo Horizonte Ensino e Pesquisa - EP/SCBH, Belo Horizonte, Brazil.,Department of Neurosurgery, Hospital Santa Casa de Belo Horizonte, Belo Horizonte, Brazil.,Faculdade de Ciências Médicas de Minas Gerais (FCMMG), Belo Horizonte, Brazil
| | | | | | - Cristiana Buzelin Nunes
- Departamento de Anatomia Patológica e Medicina Legal, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Centro Universitário de Belo Horizonte - UniBH, Belo Horizonte, Brazil
| | - Aleida Nazareth Soares
- Laboratory of Molecular Biology and Biomarkers, Santa Casa de Belo Horizonte Ensino e Pesquisa - EP/SCBH, Belo Horizonte, Brazil
| | - Luciene Simões de Assis Tafuri
- Laboratory of Molecular Biology and Biomarkers, Santa Casa de Belo Horizonte Ensino e Pesquisa - EP/SCBH, Belo Horizonte, Brazil.,Departamento de Fisiologia e Patologia, Centro de Ciências da Saúde, Universidade Federal da Paraíba, DFP/CCS/UFPB, João Pessoa, Brazil
| | - Renata Toscano Simões
- Laboratory of Molecular Biology and Biomarkers, Santa Casa de Belo Horizonte Ensino e Pesquisa - EP/SCBH, Belo Horizonte, Brazil
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Ramezani M, Firoozabadi H, Rezaei M, Khazaei S, Sadeghi M. Expression of Human Epidermal Growth Factor Receptor 2 in Meningiomas. Indian J Med Paediatr Oncol 2020. [DOI: 10.4103/ijmpo.ijmpo_10_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Background: Meningiomas consist of 15%–30% of the primary intracranial tumors, and high-grade meningiomas have a higher recurrence after surgery. The human epidermal growth factor receptor 2 (HER2) status is important in the medical management of patients with various human cancers. This study aimed to evaluate HER2 expression in meningiomas and the correlation between this expression and age, gender, and grade. Materials and Methods: In a descriptive-analytic study, immunohistochemistry (IHC) with HER2 marker was done on confirmed cases of meningioma which were referred to the pathology laboratory from 2008 to 2015. The primary antihuman antibody against c-erbB-2 oncoprotein (DAKO Diagnostics) was used for IHC. Results: Of 117 patients, 68.4% were males. The mean age of the patients was 53.6 years. Grades I, II, and III tumors were 90.6%, 8.5%, and 0.9% of cases, respectively. Totally, 76 (65%) of patients were HER2 positive, with only 7.7% of highly expressed HER2. There was no significant correlation between the mean age (P = 0.672), age group (P = 0.256), sex (P = 0.574), and grade (P = 0.093) and HER2 expression status. Conclusions: We did not find a statistically significant correlation between age, sex, or grade and HER2 status; however, further studies with a higher number of Grades II and III meningiomas and using the fluorescent in situ hybridization in equivocal cases may be of benefit in this way.
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Affiliation(s)
- Mazaher Ramezani
- Molecular Pathology Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hanieh Firoozabadi
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mansour Rezaei
- Department of Biostatistics, Fertility and Infertility Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sedigheh Khazaei
- Molecular Pathology Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Arnli MB, Meta R, Lydersen S, Torp SH. HER3 and HER4 are highly expressed in human meningiomas. Pathol Res Pract 2019; 215:152551. [PMID: 31400925 DOI: 10.1016/j.prp.2019.152551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/18/2019] [Accepted: 07/20/2019] [Indexed: 11/27/2022]
Abstract
HER3 and HER4 are tyrosine kinase receptors of the ErbB family that have been detected in several cancers but lack substantial investigation in human meningiomas. In this study, HER3 and -4 expression levels were evaluated as potential biomarkers by immunohistochemistry and explored for association to clinical features in a large series of human meningiomas. 186 primary intracranial meningiomas from adult patients were investigated with antibodies against HER3 and -4 intracellular domains. Tumors were scored with a staining index (SI) based on cytoplasmic/membranous staining intensity and on the percentage of positive cells. SIs were tested for associations with WHO malignancy grade, tumor subtype, localization, and prognosis. HER3 and HER4 were highly expressed in most tumors. Both cytoplasmic and membranous immunoreactivity occurred, and for HER4 nuclear immunoreactivity was observed as well. Non-neoplastic meningeal tissue was not immunoreactive. HER3 and -4 immunoreactivity was not associated with WHO malignancy grade, nor with recurrence or survival in adjusted analyses. Meningiomas of all grades were shown to widely express both HER3 and HER4 receptors. This feature may have diagnostic value since non-neoplastic meninges were not immunoreactive. There was no prognostic significance in adjusted survival analyses.
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Affiliation(s)
- Magnus Bossum Arnli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Faculty of Medicine and Health Sciences, Department of Clinical and Molecular Medicine (IKOM), PO Box 8905, NO-7491 Trondheim, Norway.
| | - Rahmina Meta
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Faculty of Medicine and Health Sciences, Department of Clinical and Molecular Medicine (IKOM), PO Box 8905, NO-7491 Trondheim, Norway.
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; RKBU Midt-Norge, NTNU, Postboks 8905 MTFS, NO-7491 Trondheim, Norway.
| | - Sverre Helge Torp
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Faculty of Medicine and Health Sciences, Department of Clinical and Molecular Medicine (IKOM), PO Box 8905, NO-7491 Trondheim, Norway; Department of Pathology, St. Olavs Hospital, Trondheim, Norway; St. Olavs hospital HF, Postboks 3250 Torgarden, 7006 Trondheim, Norway.
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