From the Department of Diagnostic Pathology, Nara Medical University, Nara, Japan.
Department of Diagnostic Pathology, Hyogo Cancer Center, Akashi, Hyogo, Japan.
J Neuropathol Exp Neurol. 2022 Jan 29;81(2):117-126. doi: 10.1093/jnen/nlab127.
CDKN2A homozygous deletion has occasionally been reported in atypical and anaplastic meningiomas and is considered as one of the genetic alterations commonly involved in their recurrence and malignant progression. Methylthioadenosine phosphorylase (MTAP) immunohistochemistry is a promising surrogate marker for CDKN2A homozygous deletion in different cancers but has not been examined in meningiomas. We performed CDKN2A FISH and MTAP immunohistochemistry on specimens from 30 patients with CNS WHO grade 2 (n = 27) and 3 (n = 3) meningiomas, including specimens from primary and recurrent tumors and then determined whether MTAP immunohistochemistry correlated with CDKN2A homozygous deletion and clinicopathological features. CDKN2A homozygous deletion was detected in 12% (3/26) of CNS WHO grade 2 and 67% (2/3) of CNS WHO grade 3 meningiomas; 3 cases exhibited temporal and/or spatial heterogeneity. MTAP loss was in excellent concordance with CDKN2A homozygous deletion (sensitivity; 100%, specificity; 100%). MTAP loss/CDKN2A homozygous deletion correlated with cellular proliferation (mitotic rate; p = 0.001, Ki-67 labeling index; p = 0.03) and poor prognosis (overall survival; p = 0.01, progression free survival; p < 0.001). Thus, MTAP immunostaining can be a surrogate marker for CDKN2A homozygous deletion in meningiomas, and MTAP loss/CDKN2A homozygous deletion may be an important prognostic factor for meningiomas.
CDKN2A 纯合性缺失偶尔在非典型和间变性脑膜瘤中报道,被认为是其复发和恶性进展中常见的遗传改变之一。甲基硫代腺苷磷酸化酶(MTAP)免疫组化是不同癌症中 CDKN2A 纯合性缺失的有前途的替代标志物,但尚未在脑膜瘤中进行检查。我们对 30 名 CNS WHO 2 级(n=27)和 3 级(n=3)脑膜瘤患者的标本进行了 CDKN2A FISH 和 MTAP 免疫组化检测,包括原发性和复发性肿瘤标本,然后确定 MTAP 免疫组化是否与 CDKN2A 纯合性缺失以及临床病理特征相关。在 12%(3/26)的 CNS WHO 2 级和 67%(2/3)的 CNS WHO 3 级脑膜瘤中检测到 CDKN2A 纯合性缺失;3 例表现出时间和/或空间异质性。MTAP 缺失与 CDKN2A 纯合性缺失具有极好的一致性(敏感性 100%,特异性 100%)。MTAP 缺失/CDKN2A 纯合性缺失与细胞增殖(有丝分裂率,p=0.001;Ki-67 标记指数,p=0.03)和不良预后(总生存期,p=0.01;无进展生存期,p<0.001)相关。因此,MTAP 免疫染色可以作为脑膜瘤中 CDKN2A 纯合性缺失的替代标志物,MTAP 缺失/CDKN2A 纯合性缺失可能是脑膜瘤的一个重要预后因素。
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