Low Expression of Phosphatase and Tensin Homolog and High Expression of Ki-67 as Risk Factors of Prognosis in Cranial Meningiomas

World Neurosurg. 2020 Apr:136:e196-e203. doi: 10.1016/j.wneu.2019.12.108. Epub 2019 Dec 27.

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.

Keywords: Ki-67; Meningiomas; Mortality; PTEN; Prognosis; Recurrence.

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / analysis*
  • Brain Neoplasms / pathology
  • Female
  • Humans
  • Ki-67 Antigen / analysis
  • Ki-67 Antigen / biosynthesis*
  • Male
  • Meningeal Neoplasms / pathology*
  • Meningioma / pathology*
  • Middle Aged
  • PTEN Phosphohydrolase / analysis
  • PTEN Phosphohydrolase / biosynthesis*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis

Substances

  • Biomarkers, Tumor
  • Ki-67 Antigen
  • PTEN Phosphohydrolase
  • PTEN protein, human