Authors: F Roser M Samii H Ostertag M Bellinzona
Publish Date: 2003/12/22
Volume: 146, Issue: 1, Pages: 37-44
Abstract
Background Meningiomas are mostly benign tumours that can be cured by surgical resection Because meningiomas tend to recur long term management in patients with subtotal tumour resection remains controversial Previous studies have shown that the proliferation potential of meningiomas by Ki67 labelling indices LI might predict their natural history The purpose of this study was to analyse the reliability of Ki67labelling index in predicting the behaviour of meningiomas and to help the neurosurgeon in establishing better follow up criteria and long term management strategies for these patientsMethod From 1990 to 2000 1328 meningiomas have been operated in our Neurosurgical Department A total of 600 tumours were examined immunohistochemically using the Mib1 monoclonal antibody Clinical charts of the patients including surgical histological and follow up records as well as imaging studies were analysed retrospectively Ki67 LI were correlated with neuroradiological findings 3D volumetric studies histological subtype recurrencefree survival grade of resection consistency of tumour tissue location osseous involvement en plaque appearance vascularity and progesteronereceptor statusFindings Among the 600 patients analysed there were 66 females mean LI 38 and 34 males mean LI 57 including 20 neurofibromatosistype2 NFII patients with a mean LI of 52 Histological grading revealed 91 WHO°I meningiomas mean LI 328 7 WHO°II mean LI 995 and 2 WHO°III mean LI 1218 Labelling indices in recurrent meningiomas increased from initial resection to a fourth local resection A significant correlation between negative progesteronreceptor status and high tumour vascularity with high Ki67 LI was seen Ki67 was not a statistically significant predictor of survival time in totally excised WHO°I meningiomasInterpretation Mib1 is one important tool in addition to routine histological evaluation but a combination of clinical factors and particularly the extent of surgical resection along with the biological features of the tumour should influence the decision of the neurosurgeon to the patient follow up
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