The role of vascular endothelial growth factor in predicting the tumor dynamics of meningiomas
Keywords:VEGF, High risk, Meningiomas
Background: Meningiomas are the most common tumors of the central nervous system with variable tumor dynamics. Histopathology is the gold standard but has its own constraints in predicting the tumor behavior. As intra- tumoral hypoxia leads to neo angio angiogenesis and subsequent tumor growth we envisage to establish the role of vascular endothelial growth factor (VEGF) in predicting the tumor dynamics of meningiomas.
Methods: This observational, descriptive, longitudinal follow up study included 38 patients and spanned over a period of 2 years. Surgical samples were grossed and histo-pathologically analyzed and subsequently immune-histochemically categorized. Cases showing VEGF positivity were subjected to yearly follow up to ascertain the number of recurrent cases.
Results: Majority of our cases belonged to WHO grade I (84.21%). The 73.68% were females. The 63.16% were aged >50 years. The 42.1 % of the total cases revealed moderate to strong VEGF expression. Majority of grade II and grade III meningiomas showed moderate to strong VEGF expression. However, a subgroup of grade I meningiomas also revealed a high immune-expression of VEGF (31.25%). Statistically significant association was found between VEGF expression and WHO grade (p=0.0001). On follow up 34.21% of the cases showed recurrence. Significant association was found between VEGF expression and recurrence of the tumor s (p=0.0005).
Conclusions: VEGF has a role in ascertaining the high-risk grade I meningiomas that have a potential to recur as well as grade II and grade III meningiomas that show adverse patient prognosis.
Shah S, Gonsai RN, Makwana R. Histopathological study of meningioma in civil hospital. IJCRR. 2013;5:3.
Louis DN, Ohgaki H, Wiestler OD, Cavenee KW. tumors of the central nervous system, WHO classification of tumors. Lyon IARC Press. 2016;234.
Perry A, Stafford SL, Scheithauer BW, Wollan PC, Lohse CM. malignancy in meningioma: a clinicopathologic study of 116 patients, with grading implications. Cancer. 1999;85(9):2046-56.
Hurst JH, Kaelin W, Ratcliffe P, Semenza G. Receive the 2016 Albert Lasker Basic Medical Research Award. J Clin Invest. 2016;126(10):3628-38.
Raica M, Mogoanta L, Cimpean AM, Alexa A. Immunohistochemical expression of VEGF in intestinal type gastric carcinoma. Romanian j Morphol embryo. 2008;49(1):37-42.
Nuaimy W, Jalal J, Banan MD. Ki 67 (MIB 1) and PR in meningioma. The Iraqi Postgraduate Med J. 2012;11:2.
Mukherjee S, Ghosh SN, Chatterjee U, Chatterjee S. Detection of PR and the correlation with Ki67 LI in meningiomas. Neurol India. 2011;59(6):817-22.
Butta S, Gupta MK. Study of epidemiological aspects and hormone receptor status of meningiomas. Int J Res Med Sci. 2020;8:2482-6.
Claus EB, Calvocoressi L, Bondy ML, Schildkraut KM, Wielmels JL, Wrensch M. Exogenous hormone use, reproductive factors, and risk of intracranial meningiomas in females. J Neurosurg. 2013;118(3):649-56.
Rao Sh., Sadiya N., Doraiswami S. Characterization of morphologically benign biologically aggressive meningiomas. Neurol India. 2009;57:744-8.
Perry A, Lusis EA, Gutman DH. Meningothelial hyperplasia: a detailed clinicopathologic, immunohistochemical and genetic study of 11 cases. Brain Pathol. 2005;15(2):109-15.
Dharmalingam P, Roopesh KVR, Verma SK. Vascular endothelial growth factor expression and angiogenesis in various grades and subtypes of meningiomas. Indian J Pathol Microbiol. 2013;56:349-54.
Yamasaki F, Yoshioka H, Hama S, Sugiyama K, Arita K, Kurisu K. Recurrence of meningiomas. Cancer. 2000;89(5):1102-10.
Budohoski KP, Clerkin J, Millward CP, O'Halloran PJ, Waqar M, Looby S et al. Predictors of early progression of surgically treated atypical meningiomas. Acta Neurochir. 2018;160(9):1813-22.
Lee W, Chang K H, Choe G, Chi JG, Chung CK, Kim IH et al. MR Imaging features of clear cell meningioma with diffuse leptomeningeal seedling. Am J Neuroradiol. 2000;21(1):130-2.
Liu Z, Wang C, Wang H, Wang Y, Li JY, Liu Y. Clinical characteristics and treatment of angiomatous meningiomas: a report of 27 cases. Int J Clin Exp Pathol. 2013;6(4):695-702.
Semenza GL. Defining the role of hypoxia-inducible factor 1 in cancer biology and therapeutics. Oncogene. 2010;29(5):625-34.
Brown J, Wilson W. Exploiting tumor hypoxia in cancer treatment. Nat Rev Cancer. 2004;4:437-47.