Role of HER-2/neu Overexpression and Clinical Features at Presentation as Predictive Factors in Meningiomas

Abstract

Prediction of outcome in patients with meningiomas remains a significant problem to date. We have evaluated the role of symptoms at presentation and overexpression of her-2/neu overexpression as independent prognostic factors in meningiomas. In a retrospective study on patients with biopsy-proven diagnosis of meningioma, her-2/neu overexpression was evaluated using immunohistochemistry (IHC) performed on paraffin-embedded specimens. An IHC score of > or =2+ was considered positive for overexpression. Two hundred thirty-seven patients thus identified between January 1986 and December 1999 included 149 females and 88 males, with a mean age of 63.44 years. Survival was estimated using the Kaplan-Meier method. Incidence of meningiomas in females (62.8%) was significantly greater than in males. Focal neurodeficits, headache, and seizures (39.66%) were the most common presenting complaints and were not related to tumor behavior/outcome. Syncope at presentation was associated with a decreased survival, but this symptom constituted only 2.53% of the total, so reliable conclusions could not be drawn. Only 6 (2.53%) specimens revealed HER-2/neu overexpression by IHC. HER-2/neu overexpression is not a predictor of tumor behavior and has no role as a prognostic factor in meningiomas. Syncope as the clinical presentation at diagnosis may predict a poor outcome, but needs further investigation.

Her-2/neu, Estrogen And Progesterone Receptor Expression In Who Grade I Meningiomas

“…In the present study, Her-2/neu expression was also significantly higher in meningothelial meningiomas, suggesting that Her-2/ neu expression may be associated with differentiation. No relationship has been described between Her-2/ neu overexpression and proliferative activity in previous studies, [9][10][11][12][13][14][15][16] and our results support this finding.…”

“…[8] Her-2/neu is a well-known prognostic factor in various tumurs such as breast carcinoma, although the significance of Her-2/neu expression in meningiomas is unclear. [9][10][11][12][13][14][15][16][17] In our study, Her-2/neu overexpression was detected in 22.6% of the cases, which is within the range of 2.5 to 67.3% reported for Her-2/neu overexpression in meningiomas. [9][10][11][12][13][14][15][16][17] In a study by Loussouarn et al, [12] Her-2/neu overexpression was more frequent in meningiomas displaying epithelial differentiation, such as meningothelial and secretory types.…”

“…[15,16] In contrast, Schlegel et al [14] and Potti et al [10,11] detected Her-2/ neu in non-neoplastic arachnoid cap cells. In the current study, we also observed Her-2/neu immunoreactivity at low levels in non-neoplastic meningeal tissues.…”

“…[8,9] However, the significance of Her-2/neu expression in meningiomas is currently unknown. [10][11][12][13][14][15][16] In the present study, we analyzed the immunohistochemical expression of the PR, ER, and Her-2/neu in WHO grade I meningiomas. In addition, we related the expression profiles of these factors to clinicopathological parameters such as age, gender, tumour size, brain and dura invasion, histological subtype, and proliferative index.…”

Gene Expression Profiling of ErbB Receptors and Ligands in Human Meningiomas

“…Expression of ErbB receptor and ligand genes in meningiomas remains controversial. There are reports about expression of ErbBs in most meningiomas (15) or in some of them regardless of their grade but related to the recurrence rate (16) or in a low percentage of tumors (17). One of the few studies about ErbB-ligand gene expression resulted in a frequent detection of the TGFA protein and mRNA as well as the EGF/TGFA receptor within all types and grades of meningiomas (18).…”