Clinico-pathological and radiological correlation of CNS tumors along with role of Ki 67 proliferative index in grading Astrocytoma and Meningiomas
DOI:
https://doi.org/10.18203/2320-6012.ijrms20193391Keywords:
Astrocytomas, CNS tumors, Diagnostic accuracy, Ki 67 proliferative index, Meningiomas, RadiologyAbstract
Background: CNS neoplasms are a heterogenous group contributing to <2% of all the malignant neoplasms. Imaging and histopathology play a great role in diagnosing these lesions. Aim of the study is to correlate radiological findings with that of histopathology and evaluate the role of Ki 67 proliferative index in various grades of Astrocytomas and Meningiomas
Methods: This is an observational study for a period 2 years from July 2015 to June 2017 in Department of Pathology Andhra Medical College. The total number of specimens of CNS tumors received during this period were126. The specimens were routinely processed and stained with H&E. The tumors were classified based on WHO 2016 classification. In total 71 cases-45 cases of meningiomas and 26 cases of astrocytomas, the expression of Ki 67 labelling index was recorded in various grades of these tumors and results tabulated.
Results: Among 126 cases, tumors predominantly encountered were of meningeal origin accounting to 45 cases (35.71%) followed by tumors of neuroepithelial origin 35 cases (27.78%). Tumors were seen in all age groups, but common was among 41-50 years of age group with metastatic tumors being seen in >60 year group. Tumors were more common in males with male: female ratio being 1.25:1. Ki 67 proliferative index increased as the grade of tumor increased in both astrocytomas and meningiomas.
Conclusions: Grading of meningiomas and astrocytomas are very much essential with reference to prognosis and therapy. Histopathology plays a great role in grading these lesions but Ki 67 proliferative index adds as an adjunct and helps in confirmation and predicting the recurrence of these lesions.
References
Masoodi T, Gupta RK, Singh JP, Khajuria A. Pattern of central nervous system neoplasm: A study of 106 cases. JK Pract. 2012;17:42-6.
Yeole BB. Trends in the brain cancer incidence in India. Asian Pac J Cancer Prev. 2008;9(2):267-70.
Thotakura M, Tirumalasetti N, Krishna R. Role of Ki 67 labeling index as an adjunct to the histopathological diagnosis and grading of astrocytomas. J cancer res therapeut. 2014;10(3):641.
Quiñones-Hinojosa A, Sanai N, Smith JS, McDermott MW. Techniques to assess the proliferative potential of brain tumors. J neuro-oncol. 2005;74(1):19-30.
Louis DN, Perry A, Reifenberger G, Von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta neuropathol. 2016;131(6):803-20.
Babu S, Uppin SG, Uppin MS, Panigrahi MK, Saradhi V, Bhattacharjee S, et al. Meningiomas: correlation of Ki 67 with histological grade. Neurol Ind. 2011;59(2):204.
Jalali R, Datta D. Prospective analysis of incidence of central nervous tumors presenting in a tertiary cancer hospital from India. J Neuro-oncol. 2008;87(1):111.
Jamal S, Mamoon N, Mushtaq S, et al. Pattern of Central Nervous System (CNS) Tumours: A study of 430 cases. Pak J Pathol 2005;16(4):106-109.
Das A, Chapman CA, Yap WM. Histological subtypes of symptomatic central nervous system tumours in Singapore. J Neurol, Neurosurg Psychiat. 2000;68(3):372-4.
Suh YL, Koo H, Kim TS, Chi JG, Park SH, Khang SK, et al. Tumors of the Central Nervous System in Korea A Multicenter Study of 3221 Cases. J neuro-oncol. 2002;56(3):251-9.
Lee CH, Jung KW, Yoo H, Park S, Lee SH. Epidemiology of primary brain and central nervous system tumors in Korea. J Korean Neurosurg Soc. 2010;48(2):145.
Lakshmi S. Meningiomas: a clinico pathological study Int J Med Res Health Sci. 2015;4(4):827-831.
Shah AB, Muzumdar GA, Chitale AR. Meningiomas: report of a hospital-based registry. Ind J pathol microbiol. 2005;48(4):468-71.
Khaled R Zalata, Dina A El Tantawy, Azaa Abdel Aziz, Abdel Wahab M Ibraheim, Ahmed H Halaka, Hasan H Gawish, et al; Frequency of CNS tumors in the delta region, Egypt; Ind J pathol Microbiol 2011: 54(2)299-06
Mukherjee S, Ghosh SN, Chatterjee U, Chatterjee S. Detection of progesterone receptor and the correlation with Ki 67 labeling index in meningiomas. Neurol Ind. 2011;59(6):817.
Lalitha VS, Dastur DK. Neoplasms of the central nervous system-histological types in 2237 cases. Ind J cancer. 1980;17(2):102-6.
Schellinger KA, Propp JM, Villano JL, McCarthy BJ. Descriptive epidemiology of primary spinal cord tumors. J neuro-oncol. 2008;87(2):173-9.
Kaye AH, Giles GG, Gonzales M. Primary central nervous system tumours in Australia: a profile of clinical practice from the Australian Brain Tumour Register. Aus New Zeal J Surg. 1993;63(1):33-8.
Cheang CM, Hwang SL, Hwong SL. An analysis of intraspinal tumors in south Taiwan. The Kaohsiung J med sci. 1997;13(4):229-36.
Engelhard HH, Villano JL, Porter KR, Stewart AK, Barua M, Barker FG, et al. Clinical presentation, histology, and treatment in 430 patients with primary tumors of the spinal cord, spinal meninges, or cauda equina. J Neurosurg: Spine. 2010;13(1):67-77.
Moein P, Behnamfar O, Khalighinejad N, Farajzadegan Z, Fard SA, Razavi M, et al.12-year epidemiologic study on primary spinal cord tumors in Isfahan, Iran. J res in med sci: offic J Isfahan Univ Med Sci. 2013;18(1):17.
Nitin M Gadgil, Chetan Sudhakar Chaudhari, Sangeeta R Margam, Mohd. UnzerMohd. Umar Khan, Prashant Vijay Kumavat, et al. A clinicopathological study of lesions of spinal cord and its coverings: A tertiary care hospital experience. Ann Pathol Lab Med. 2016;03(03).
Raj Kumar, Alex Daniel Prabhu Arul Pitchai, Srinivasa Mudali. Diagnostic Accuracy of Magnetic Resonance Imaging in Characterizing Intracranial Space Occupying Lesions: A Cross-sectional Study International J Scient Stud.2016;4(3).
