• World Neurosurg · Apr 2020

    Low expression of PTEN and high expression of Ki-67 as risk factors of prognosis in cranial meningiomas.

    • Junpeng Ma, Yuan Zhang, Liangpeng Chen, Yujia Chen, Yang Yang, Da Li, Liang Wang, Junting Zhang, and Zhen Wu.
    • Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
    • World Neurosurg. 2020 Apr 1; 136: e196-e203.

    ObjectiveTo investigate the expression characteristics, correlations with clinical factors, and prognostic values of phosphatase and tensin homolog (PTEN) and Ki-67 in cranial meningiomas.MethodsThe 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.ResultsTwenty-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.ConclusionsA low PTEN expression and a high Ki-67 expression could predict malignancy in cranial meningiomas.Copyright © 2019 Elsevier Inc. All rights reserved.

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