Histopathology and MIB-1 labeling index predicted recurrence of meningiomas
A proposal of diagnostic criteria for patients with atypical meningioma
Article first published online: 11 MAR 2002
Copyright © 2002 American Cancer Society
Volume 94, Issue 5, pages 1538–1547, 1 March 2002
How to Cite
Ho, D. M.-T., Hsu, C.-Y., Ting, L.-T. and Chiang, H. (2002), Histopathology and MIB-1 labeling index predicted recurrence of meningiomas. Cancer, 94: 1538–1547. doi: 10.1002/cncr.10351
- Issue published online: 11 MAR 2002
- Article first published online: 11 MAR 2002
- Manuscript Accepted: 24 OCT 2001
- Manuscript Revised: 17 OCT 2001
- Manuscript Received: 13 AUG 2001
- Veterans General Hospital-Taipei. Grant Number: 90-365
Although various histopathologic features have been associated with aggressive behavior or recurrence of meningiomas, there is little agreement about which features are the most important and in what combination. The objective of this study was to formulate diagnostic criteria for atypical meningioma.
Eighty-three patients with meningiomas who underwent macroscopic total resection and had been followed until they developed recurrent disease or for at least 10 years were studied. Thirteen histopathologic parameters that related to recurrence of the tumor were evaluated in each patient. All possible combinations of histologic parameters that were related significantly to recurrence were used to formulate scoring models. The model that included the fewest parameters and that could distinguish tumor recurrence best within 10 years was chosen as the final model.
The final model included three parameters: loss of architecture, mitoses ≥ 1.5/mm2, and necrosis. Of the 52 tumors with a score < 2 (0 or 1 of the 3 parameters), all except 1 tumor did not recur within 10 years, and they were all considered benign meningiomas. Of the 31 tumors with a score ≥ 2 (2 or 3 of the 3 parameters), 94% recurred within 10 years (76% recurred within 5 years), and they were considered atypical meningiomas. The estimated 5-year and 10-year recurrence rates for the benign meningiomas were 0.0% and 1.9%, respectively, for benign meningiomas and 71.0% and 93.5%, respectively, for atypical meningiomas (P < 0.001). The estimated 5-year and 10-year mortality rates also were significantly different (0.0% and 0.0% vs. 22.1% and 26.7%, respectively; P < 0.001). The MIB-1 labeling index (LI) for the entire group studied ranged from 0.4 to 33.5 (mean LI, 8.4). Fifty-two tumors with an LI of < 10 did not recur within 10 years. Of the 31 tumors with an LI ≥ 10, 97% recurred (71% within 5 years).
Histopathology and MIB-1 LI were able to predict clinical outcomes of patients with meningioma. The authors propose that atypical meningioma may be diagnosed when two of the following three criteria are present: loss of architecture, mitoses ≥ 1.5/mm2, and necrosis. Cancer 2002;94:1538–47. © 2002 American Cancer Society.