Chavali Pooja, Uppin Megha S, Uppin Shantveer G, Challa Sundaram
Department of Pathology, Guntur Medical College, Guntur, Andhra Pradesh, India.
Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Neurol India. 2017 Nov-Dec;65(6):1345-1349. doi: 10.4103/0028-3886.217934.
The most reliable histological correlate of recurrence risk in meningiomas is increased mitotic activity. Proliferative index with Ki-67 immunostaining is a helpful adjunct to manual counting. However, both show considerable inter-observer variability. A new immunohistochemical method for counting mitotic figures, using antibody against the phosphohistone H3 (PHH3) protein was introduced. Similarly, a computer based automated counting for Ki-67 labelling index (LI) is available.
To study the use of these new techniques in the objective assessment of proliferation indices in meningiomas.
This was a retrospective study of intracranial meningiomas diagnosed during the year 2013.The hematoxylin and eosin (H and E) sections and immunohistochemistry (IHC) with Ki-67 were reviewed by two pathologists. Photomicrographs of the representative areas were subjected to Ki-67 analysis by Immunoratio (IR) software. Mean Ki-67 LI, both manual and by IR were calculated. IHC with PHH3 was performed. PHH3 positive nuclei were counted and mean values calculated. Data analysis was done using SPSS software.
A total of 64 intracranial meningiomas were diagnosed. Evaluation on H and E, PHH3, Ki-67 LI (both manual and IR) were done in 32 cases (22 grade I and 10 grade II meningiomas). Statistically significant correlation was seen between the mitotic count in each grade and PHH3 values and also between the grade of the tumor and values of Ki-67 and PHH3.
Both the techniques used in the study had advantage over, as well as, correlated well with the existing techniques and hence, can be applied to routine use.
脑膜瘤复发风险最可靠的组织学相关因素是有丝分裂活性增加。Ki-67免疫染色的增殖指数有助于辅助人工计数。然而，两者在观察者间均显示出相当大的变异性。一种使用抗磷酸化组蛋白H3（PHH3）蛋白抗体计数有丝分裂象的新免疫组化方法被引入。同样，也有基于计算机的Ki-67标记指数（LI）自动计数方法。
研究这些新技术在客观评估脑膜瘤增殖指数中的应用。
这是一项对2013年诊断的颅内脑膜瘤的回顾性研究。两名病理学家对苏木精和伊红（H&E）切片以及Ki-67免疫组化（IHC）进行了复查。代表性区域的显微照片通过免疫比率（IR）软件进行Ki-67分析。计算手动和通过IR得出的平均Ki-67 LI。进行了PHH3免疫组化。对PHH3阳性细胞核进行计数并计算平均值。使用SPSS软件进行数据分析。
共诊断出64例颅内脑膜瘤。对32例（22例I级和10例II级脑膜瘤）进行了H&E、PHH3、Ki-67 LI（手动和IR）评估。各分级中的有丝分裂计数与PHH3值之间以及肿瘤分级与Ki-67和PHH3值之间均存在统计学上的显著相关性。
本研究中使用的两种技术均优于现有技术，且与现有技术相关性良好，因此可应用于常规使用。
