The prognostic role of Ki-67/MIB-1 in meningioma

Liu, Ning; Song, Shu; Jiang, Jiabao; Wang, Tingjian; Chen, Yan

doi:10.1097/md.0000000000018644

Cited by 68 publications

(60 citation statements)

References 75 publications

(52 reference statements)

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“…Negative predictors for tumor progression in meningioma include male sex, young age, low Karnofsky performance status, high WHO grade, high mitotic rate, subtotal resection, and involvement of the optic nerve [ 24 ]. A high MIB-1 labeling index is strongly associated with shorter progression-free survival in meningioma and positively correlates with the meningioma grade [ 13 , 25 , 26 ]. In a typically elective setting, it is particularly important that patients and their relatives are provided with most comprehensive consultation possible.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the detection of this antigen is a feasible technique in order to determine the growing fraction of a neoplastic cell tissue sample [ 7 , 8 , 9 ]. Moreover, numerous studies and a recent meta-analysis have shown that the Ki-67/MIB-1 labeling index is an independent predictor of progression-free survival (PFS) in meningiomas [ 10 , 11 , 12 , 13 ]. To achieve the best possible long-term outcome with regard to tumor recurrence, appropriate preoperative assessment, effective communication about the aims of surgery, and function-preserving surgery are essential.…”

Section: Introductionmentioning

confidence: 99%

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FORGE: A Novel Scoring System to Predict the MIB-1 Labeling Index in Intracranial Meningiomas

Wach

Lampmann

Güresir

et al. 2021

Cancers

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The MIB-1 index is an essential predictor of progression-free-survival (PFS) in meningioma. To date, the MIB-1 index is not available in preoperative treatment planning. A preoperative score estimating the MIB-1 index in patients with intracranial meningiomas has not been investigated so far. Between 2013 and 2019, 208 patients with tumor morphology data, MIB-1 index data, and plasma fibrinogen and serum C-reactive protein (CRP) data underwent surgery for intracranial WHO grade I and II meningioma. An optimal MIB-1 index cut-off value (≥6/<6) in the prediction of recurrence was determined by ROC curve analysis (AUC: 0.71; 95% CI: 0.55–0.87). A high MIB-1 index (≥6%) was present in 50 cases (24.0%) and was significantly associated with male sex, peritumoral edema, low baseline CRP, and low fibrinogen level in the multivariate analysis. A scoring system (“FORGE”) based on sex, peritumoral edema, preoperative CRP value, and plasma fibrinogen level supports prediction of the MIB-1 index (sensitivity 62%, specificity 79%). The MIB-1 labeling index and the FORGE score are significantly associated with an increased risk of poor PFS time. We suggest a novel score (“FORGE”) to preoperatively estimate the risk of an increased MIB-1 index (≥6%), which might help in surgical decision making and follow-up interval determination and inform future trials investigating inflammatory burden and proliferative activity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

FORGE: A Novel Scoring System to Predict the MIB-1 Labeling Index in Intracranial Meningiomas

Wach

Lampmann

Güresir

et al. 2021

Cancers

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“…Even in modern cohorts with extended follow-up, Simpson Grade 1 resections more than double the chance of progression-free survival, especially in high-grade meningiomas ( 19 ). In addition to Simpson grade, higher initial tumor size and MIB-1/Ki-67 indices, as well as presence of necrosis may decrease progression- and recurrence-free survival ( 19 – 22 ).…”

Section: Prognostic Factors For Meningiomasmentioning

confidence: 99%

Basis for Immunotherapy for Treatment of Meningiomas

et al. 2020

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Meningiomas are common tumors that account for approximately one third of CNS tumors diagnosed every year. They are classified by the World Health Organization in grades I-III. Higher grades have an increased rate of growth, invasiveness, rate of recurrence, and worse outcomes than lower grades. Most meningiomas are grade I, while ~18% of meningiomas are grade II and III in hospital-based series. Meningiomas are typically “benign” tumors that are treated with surgery and radiation. However, when they recur or are unresectable, treatment options are very limited, especially since they are chemotherapy-resistant. Recent advances in the treatment of cancers with immunotherapy have focused on checkpoint blockade as well as other types of immunotherapy. There is emerging evidence supporting the use of immunotherapy as a potentially effective treatment strategy for meningioma patients. The immune microenvironment of meningiomas is a complex interplay of genetic alterations, immunomodulatory protein expression, and tumor-immune cell interactions. Meningiomas are known to be infiltrated by immune cells including microglia, macrophages, B-cells, and T-cells. Several mechanisms contribute to decreased an ti-tumor immune response, allowing tumor growth and evasion of the immune system. We discuss the most current knowledge on the immune micro-environment of meningiomas, preclinical findings of immunotherapy in meningiomas, meningioma immunotherapy clinical trials, and also offer insight into future prospects for immunotherapies in meningiomas.

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“…Ki-67 has been widely used in studies of the proliferative potential of meningiomas ( 22 ). A recent meta-analysis by Liu et al indicated a significant adverse prognostic value of a high Ki-67 expression level in the prognosis of meningiomas, and 4% was recommended as the appropriate cutoff value ( 47 ). Of their 43 included studies (comprising 5012 patients), only seven specifically targeted WHO grade II meningiomas and evaluated the prognostic value of Ki-67 expression in tumor recurrence ( 11 – 14 , 48 – 50 ).…”

Section: Discussionmentioning

confidence: 99%

Malignant Progression Contributes to the Failure of Combination Therapy for Atypical Meningiomas

Zhang

Zheng

et al. 2021

Front. Oncol.

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ObjectiveTo investigate the independent risk factors for recurrence in intracranial atypical meningiomas (AMs) treated with gross total resection (GTR) and early external beam radiotherapy (EBRT).MethodsClinical, radiological, and pathological data of intracranial AMs treated with GTR-plus-early-EBRT between January 2008 and July 2016 were reviewed. Immunohistochemical staining for Ki-67 was performed. Kaplan–Meier curves and univariate and multivariate Cox proportional hazards regression analyses were used to explore independent predictors of tumor recurrence. Chi square test was performed to compare variables between subgroups.ResultsForty-six patients with intracranial AMs underwent GTR and early EBRT. Ten (21.7%) recurred and three (6.5%) died during a median follow-up of 76.00 months. Univariate and multivariate Cox analyses revealed that malignant progression (MP) (P = 0.009) was the only independent predictor for recurrence, while Ki-67 was of minor value in this aspect (P = 0.362). MP-AMs had a significantly higher recurrence rate (P = 0.008), a higher proportion of irregularly shaped tumors (P = 0.013) and significantly lower preoperative Karnofsky Performance Scale (KPS) scores (P = 0.040) than primary (Pri) AMs. No significant difference in Ki-67 expression was detected between these subgroups (P = 0.713).ConclusionsMP was significantly correlated with an increased incidence of recurrence in GTR-plus-early-EBRT-treated intracranial AMs. Significantly higher frequencies of tumor relapse and irregularly shaped tumors and lower preoperative KPS scores were observed in MP-AMs compared with Pri-AMs. Ki-67 expression is of minor value in predicting tumor recurrence or distinguishing tumor origins in AMs.

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The prognostic role of Ki-67/MIB-1 in meningioma

Abstract: Supplemental Digital Content is available in the text

Cited by 68 publications

References 75 publications

FORGE: A Novel Scoring System to Predict the MIB-1 Labeling Index in Intracranial Meningiomas

FORGE: A Novel Scoring System to Predict the MIB-1 Labeling Index in Intracranial Meningiomas

Basis for Immunotherapy for Treatment of Meningiomas

Malignant Progression Contributes to the Failure of Combination Therapy for Atypical Meningiomas

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