Department of Neurosurgery, Helios Clinic Erfurt, Nordhaeuser Str. 74, 99089, Erfurt, Germany.
Department of Pathology and Neuropathology, Helios Clinic Erfurt, Nordhaeuser Str. 74, 99089, Erfurt, Germany.
Neurosurg Rev. 2024 May 28;47(1):241. doi: 10.1007/s10143-024-02485-y.
To analyze the correlation of KI-67-Proliferation Index (KI-67-PI) with preoperative patients and MRI characteristics, WHO grading, histological subtype and long-term-course of patients with newly diagnosed intracranial meningiomas (IM). In this single-center retrospective study, all consecutive patients with IM were analyzed from January 2007 to August 2019. Patient´s demographics (age, sex), imaging parameters (location, volume, edema, necrosis), and tumor features (WHO grade, histology) were assessed and correlated with KI-67-PI. Long-term data were retrieved from patient's last follow-up visits. This study included 463 IM in 457 surgically treated patients. Males exhibited a higher KI-67-PI than females (7.31 ± 0.22 vs. 5.37 ± 0.53; p < 0.01, Mann-Whitney U Test). Age positively correlated with KI-67-PI in both sexes (p < 0.01, Spearman), with older patients having a higher KI-67-PI. KI-67-PI was significantly higher in convexity IM compared to frontobasal IM (7.15 ± 5.56 vs. 4.66 ± 2.94; p < 0.05, ANOVA, Tukey´s HSD), while no difference in KI-67-PI expression was found when other locations were compared to each other (Tukey´s HSD). Higher KI-67-PI was significantly correlated with larger tumor volume (p < 0.01, Spearman), larger tumor necrosis and larger peritumoral edema (p < 0.01, Kruskal-Wallis). Patients with recurrent IM had a significantly higher KI-67-PI than patients without recurrence (8.24 ± 5.88 vs. 5.14 ± 3.53; p < 0.01, ANOVA, Tukey´s HSD) during a mean follow-up period of 80.92 ± 38.1 months. Atypical and anaplastic IM exhibited significantly higher KI-67-PI compared to all other WHO grade 1 histological subtypes (12.09 ± 0.73 vs. 4.51 ± 0.13; p < 0.01, Kruskal-Wallis test) and KI-67-PI was significantly higher in anaplastic IM compared to atypical meningioma (19.67 ± 1.41 vs. 11.01 ± 0.38; p < 0.01, ANOVA). Higher KI-67-PI is not only associated with atypical and anaplastic subtypes of IM, but is also significantly higher in males, positively correlates with patients age, larger tumor volume, lager peritumoral edema and necrosis on preoperative MRI and predicts tumor recurrence. Therefore, KI-67-PI may serve as a decision indicator for adjuvant treatment in patients with IM.
分析新诊断颅内脑膜瘤（IM）患者术前患者和 MRI 特征、世界卫生组织（WHO）分级、组织学亚型与长期病程的 KI-67 增殖指数（KI-67-PI）之间的相关性。在这项单中心回顾性研究中，分析了 2007 年 1 月至 2019 年 8 月期间连续收治的所有 IM 患者。评估患者的人口统计学特征（年龄、性别）、影像学参数（位置、体积、水肿、坏死）和肿瘤特征（WHO 分级、组织学），并与 KI-67-PI 相关联。从患者的最后一次随访中检索长期数据。本研究纳入了 457 例接受手术治疗的 463 例 IM 患者。男性的 KI-67-PI 高于女性（7.31±0.22 vs. 5.37±0.53；p<0.01，Mann-Whitney U 检验）。年龄与两性的 KI-67-PI 呈正相关（p<0.01，Spearman），年龄越大 KI-67-PI 越高。凸面 IM 的 KI-67-PI 明显高于额底基 IM（7.15±5.56 vs. 4.66±2.94；p<0.05，ANOVA，Tukey's HSD），而其他部位之间的 KI-67-PI 表达无差异（Tukey's HSD）。较高的 KI-67-PI 与较大的肿瘤体积（p<0.01，Spearman）、较大的肿瘤坏死和较大的瘤周水肿（p<0.01，Kruskal-Wallis）显著相关。复发 IM 患者的 KI-67-PI 明显高于无复发患者（8.24±5.88 vs. 5.14±3.53；p<0.01，ANOVA，Tukey's HSD），平均随访时间为 80.92±38.1 个月。非典型和间变性脑膜瘤的 KI-67-PI 明显高于所有其他 WHO 分级 1 组织学亚型（12.09±0.73 vs. 4.51±0.13；p<0.01，Kruskal-Wallis 检验），间变性脑膜瘤的 KI-67-PI 明显高于非典型脑膜瘤（19.67±1.41 vs. 11.01±0.38；p<0.01，ANOVA）。较高的 KI-67-PI 不仅与非典型和间变性脑膜瘤亚型相关，而且在男性中也显著升高，与患者年龄呈正相关，与术前 MRI 上较大的肿瘤体积、较大的瘤周水肿和坏死有关，并且预测肿瘤复发。因此，KI-67-PI 可作为脑膜瘤患者辅助治疗的决策指标。
