scholarly journals Meningiomas in Premenopausal Women: Role of the Hormone Related Conditions

2020 ◽  
Vol 10 ◽  
Author(s):  
Francesco Maiuri ◽  
Giuseppe Mariniello ◽  
Teresa Somma ◽  
Elia Guadagno ◽  
Sergio Corvino ◽  
...  

BackgroundSeveral epidemiological and pathological findings suggest that the female sex hormones may influence the development of meningiomas. However, the role of pregnancy, oral contraceptives, and fertilization therapies is still controversial.MethodsFrom the surgical series of 354 patients with meningiomas operated between 2006 and 2019, the group of 72 premenopausal women was separately considered. The tumor location, WHO grade, Ki67-labeling index (LI), progesterone receptor (PR) expression, and histological types were studied in premenopausal women with and without hormone-related conditions were compared.ResultsIn this premenopausal group, 24 patients had hormone-related conditions, including use of oral contraceptives in 16, intrauterine fertilization in one, pregnancy in three, and tumors of the female reproductive system in four. The group of patients with hormone-related conditions, as compared to that with no hormone related conditions, showed slightly lower median age (38 versus 43 years) and no significant difference of meningioma location WHO grade, Ki 67-Li, PR expression and histological type. The clinical onset during pregnancy in three patients and tumor growth during contraceptive progesterone therapy in two others were evidenced.ConclusionThe biological behavior of meningiomas and their pathological findings, including PR expression, are not correlated with the different hormone related conditions in premenopausal female patients. Contraceptives and fertilization therapies, mainly with progesterone, should be avoided in patients with meningiomas.

2020 ◽  
Vol 10 ◽  
Author(s):  
Yuki Kuranari ◽  
Ryota Tamura ◽  
Noboru Tsuda ◽  
Kenzo Kosugi ◽  
Yukina Morimoto ◽  
...  

BackgroundMeningiomas are the most common benign intracranial tumors. However, even WHO grade I meningiomas occasionally show local tumor recurrence. Prognostic factors for meningiomas have not been fully established. Neutrophil-to-lymphocyte ratio (NLR) has been reported as a prognostic factor for several solid tumors. The prognostic value of NLR in meningiomas has been analyzed in few studies.Materials and MethodsThis retrospective study included 160 patients who underwent surgery for meningiomas between October 2010 and September 2017. We analyzed the associations between patients’ clinical data (sex, age, primary/recurrent, WHO grade, extent of removal, tumor location, peritumoral brain edema, and preoperative laboratory data) and clinical outcomes, including recurrence and progression-free survival (PFS).ResultsForty-four meningiomas recurred within the follow-up period of 3.8 years. WHO grade II, III, subtotal removal, history of recurrence, Ki-67 labeling index ≥3.0, and preoperative NLR value ≥2.6 were significantly associated with shorter PFS (P < 0.001, < 0.001, 0.002, < 0.001, and 0.015, respectively). Furthermore, NLR ≥ 2.6 was also significantly associated with shorter PFS in a subgroup analysis of WHO grade I meningiomas (P = 0.003). In univariate and multivariate analyses, NLR ≥2.6 remained as a significant predictive factor for shorter PFS in patients with meningioma (P = 0.014).ConclusionsNLR may be a cost-effective and novel preoperatively usable biomarker in patients with meningiomas.


2020 ◽  
Author(s):  
Zhiying Lin ◽  
Runwei Yang ◽  
Yawei Liu ◽  
Kaishu Li ◽  
Guozhong Yi ◽  
...  

Abstract Objective: Age is associated with the prognosis of glioma patients, but there is no uniform standard of age-group classification to evaluate the prognosis of glioma patients. In this study, we aimed to establish an age group classification for risk stratification in glioma patients. Methods: A total of 1502 patients diagnosed with gliomas at Nanfang Hospital between 2000 and 2018 were enrolled. The WHO grade of glioma was used as a dependent variable to evaluate the effect of age on risk stratification. The evaluation model was established by logistic regression, and the Akaike information criterion (AIC) value of the model was used to determine the optimal cutoff points for age-classification. The differences in gender, WHO grade, pathological subtype, tumor cell differentiation direction, tumor size, tumor location, and molecular markers between different age groups were analyzed. The molecular markers included GFAP, EMA, MGMT, p53, NeuN, Oligo2, EGFR, VEGF, IDH1, Ki-67, 1p/19q, PR, CD3, H3K27M, and TS. Results: The proportion of men with glioma was higher than that of women with glioma (58.3% vs 41.7%). Analysis of age showed that appropriate classifications of age group were 0-14 years old (pediatric group), 15-47 years old (youth group), 48-63 years old (middle-aged group), and ≥64 years old (elderly group).The proportions of glioblastoma and large tumor size (4-6 cm) increased with age (p = 0.000, p = 0.018, respectively ). Analysis of the pathological molecular markers across the four age groups showed that the proportion of patients with larger than 10% area of Ki-67 expression or positive PR expression increased with age (p = 0.000, p = 0.017, respectively). Conclusion: Age was effective evaluating the risk of glioblastoma in glioma patients. Appropriate classifications of age group for risk stratification were 0-14 years old (pediatric group), 15-47 years old (young group), 48-63 years old (middle age group) and ≥ 64 years old (elderly group). There was significant heterogeneity in WHO grade, tumor size, tumor location and some molecular markers among the four age groups.


1997 ◽  
Vol 34 (2) ◽  
pp. 138-145 ◽  
Author(s):  
G. Minkus ◽  
U. Jütting ◽  
M. Aubele ◽  
K. Rodenacker ◽  
P. Gais ◽  
...  

Canine pancreatic neuroendocrine tumors were studied using different image analysis techniques (nuclear image histometry, analysis of argyrophilic proteins of nucleolar organizer regions, determination of the mouse anti-Ki 67 antigen proliferation index, and DNA densitometry) to correlate their biological behavior with objective phenotypic markers. The methods were compared to determine the best method for distinguishing between metastatic and nonmetastatic tumors. Discrimination between the two types of tumor was possible using nuclear image histometry in combination with morphometric analysis of argyrophilic proteins of nucleolar organizer regions. In contrast, the mouse anti-Ki 67 antigen proliferation index, DNA measurement, and immunohistochemical parameters revealed no significant difference between the two types of tumors.


2020 ◽  
Vol 30 (6) ◽  
pp. 1232-1237
Author(s):  
Meydan Turan ◽  
Gulay Turan

Purpose: Pterygium is a common lesion of the ocular surface, and its etiology and pathogenesis are still uncertain. This study aimed to investigate the role of apoptosis and proliferation in pterygium formation and recurrence. Materials and methods: In this study, p53, Bcl-2, and Ki-67 expression levels were evaluated in primary pterygium ( n = 35) and recurrent pterygium ( n = 32) tissue samples and compared with normal conjunctiva ( n = 30) tissue samples. In addition, recurrent pterygiums were divided into three groups based on recurrence time, and their p53, Bcl-2, and Ki-67 expression levels were compared. Results: The results show that p53, Bcl-2, and Ki-67 expression levels were significantly higher in the pterygium tissue samples as compared to the control group ( p < 0.001, p < 0.001, and p < 0.001, respectively). When primary and recurrent pterygium tissues were compared, bcl-2 expression was higher in recurrent pterygium tissue samples ( p = 0.003). However, when Ki-67 and p53 expression levels were evaluated, no significant difference was found between primary and recurrent pterygium ( p = 0.215, p = 0.321, respectively). Also, p53 and Ki-67 expression were correlated in pterygium tissue samples, and Bcl-2 expression was significantly higher in pterygium that recurrence in the first 6 months after surgery. There was no difference between groups 1, 2, and 3 in terms of p53 and Ki-67 expression. Conclusion: Antiapoptotic mechanisms and proliferation play an important role in the etiopathogenesis of pterygium. Furthermore, Bcl-2 expression may be important in pterygium recurrence.


Author(s):  
Marcos Devanir Silva da Costa ◽  
Nicole Cavalari Camargo ◽  
Patricia Alessandra Dastoli ◽  
Jardel Mendonça Nicácio ◽  
Frederico Adolfo Benevides Silva ◽  
...  

OBJECTIVETumors of the CNS are the main causes of childhood cancer and have an incidence that exceeds that of leukemia. In addition, they are the leading causes of cancer-related death in childhood. High-grade gliomas account for 11% of such neoplasms and are characterized by aggressive clinical behavior and high morbidity and mortality. There is a lack of studies focusing on the factors that can prolong survival in these patients or guide therapeutic interventions. The authors aimed to investigate the factors related to longer survival durations, with a focus on reoperation for gross-total resection (GTR).METHODSIn this retrospective cohort study, the authors analyzed 78 patients diagnosed with high-grade gliomas occurring across all CNS locations except diffuse intrinsic pontine gliomas. Patients 0 to < 19 years of age were followed up at the Pediatric Oncology Institute. Overall survival (OS) and progression-free survival (PFS) were analyzed in the context of various prognostic factors, such as age, sex, histology, extent of tumor resection, reoperation for GTR, adjuvant treatment, and treatment initiation from 2010 onward.RESULTSWith a mean age at diagnosis of 8.7 years, 50% of the patients were female and approximately 39% underwent GTR at some point, which was already achieved in approximately 46% of them in the first surgery. The median OS was 17 months, and PFS was 10 months. In terms of median OS, the authors found no significant difference between those with reoperation for GTR and patients without GTR during treatment. Significant differences were observed in the OS in terms of the extent of resection in the first surgery, age, sex, Ki-67 expression, adjuvant treatment, and treatment initiation from 2010 onward. Furthermore, the PFS values significantly differed between those with GTR in the first surgery and Ki-67 expression ≥ 50%.CONCLUSIONSThis study demonstrates the importance of GTR for these neoplasms, highlights the role of surgeons in its achievement in the first attempt, and questions the role of reoperation for this purpose. Finally, this study further supports the use of combined adjuvant treatment for the improvement of OS and PFS.


2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi150-vi150
Author(s):  
Niveditha Manjunath ◽  
Prerna Jha ◽  
Amol Raheja ◽  
Vaishali Suri ◽  
Ashish Suri ◽  
...  

Abstract H3K27M Diffuse Midline Gliomas (DMGs) are amongst the most fatal cancers, considered WHO grade IV irrespective of the histological features. Treatment modalities have been ineffective in prolonging survival. The aim was to determine the clinico-pathologic, molecular and immunological characteristics of DMGs in children and adults. Genetic (H3K27M, ATRX, IDH1, p53) and immune (CD3,CD8 and PD-L1) profile of 126 DMGs identified over 10 years was studied with immunohistochemistry (IHC). Sanger sequencing performed for IDH1 and H3K27M mutation. Clinico-radiologic characteristics were reviewed and survival analysis performed. Of the 126 DMGs, 49.2% H3K27M mutant and 50.8% wildtype cases (mean age 21.27 years vs. 36.23 years). 75.68% of pediatric whereas 38.20% of adults were H3K27M mutant. Brainstem (46%) was commonest site in H3K27M mutant pediatric cases while majority of adults (62%) were thalamic. H3K27M was mutually exclusive with IDH mutation in 92.5% cases, whereas p53, ATRX mutation was 56.4% and 30.6% respectively. IHC showed 95% concordance with Sanger sequencing for H3K27M mutation. PD-L1 expression was greater in elderly (>50 years), than young adults and pediatric cases (p=0.002). CD8 expression was greater in adult then pediatric cases (p=0.0001). Overall survival (OS) was not statistically significant in mutant versus wildtype cases in children (p=0.45) as well as adults (p=0.65). Tumor location showed no correlation with OS. Tumor resection independently or on correlation with H3K27M did not influence OS (p=0.505 and p=0.470). Adjuvant therapy impacted survival significantly in adults (p=0.0009) than in pediatric patients (p=0.0669) The study highlights the differences in frequency and location of pediatric and adult H3K27M mutant DMGs. Dismal prognosis in both age groups of H3K27M mutant and wild type DMGs. IHC for H3K27M mutation is an excellent substitute to Sanger sequencing. Our analysis emphasises the role of molecular characterisation for the development of effective therapeutic strategies, for different DMG subgroups.


2015 ◽  
Vol 9 ◽  
pp. CMO.S22456 ◽  
Author(s):  
Miliana T. Lucato ◽  
Ruffo Freitas-Junior ◽  
Marise A. R. Moreira ◽  
Júlio R. M. Bernardes-Junior ◽  
Sebastião A. Pinto ◽  
...  

Objectives To compare the effects of tamoxifen and raloxifene on the proliferative activity of normal breast tissue in premenopausal women as measured by Ki-67/MIB-1 expression. Study Design A total of 48 women with benign breast nodules and a recommendation for surgical removal of the lesion took part in this study. They were randomized to use tamoxifen or raloxifene for 22 days, after which they were submitted to surgery. During the surgical procedure, a 1-cm fragment of normal breast tissue was removed to study Ki-67 expression. Results The mean percentage ratios between immunolabeled and non-labeled cells were 2.02 ± 1.09 and 3.13 ± 3.23 for the tamoxifen and raloxifene groups, respectively. There was no statistically significant difference between the tamoxifen ( n = 16) and raloxifene ( n = 14) groups in relation to the immunohistochemical analysis of Ki-67 ( P = 0.205). Conclusion The results of this study showed no difference between tamoxifen and raloxifene with respect to the potential of these drugs to reduce the proliferative activity of the normal breast epithelium in premenopausal women.


2021 ◽  
Author(s):  
Hainan Li ◽  
Jieyun Tan ◽  
Mingyao Lai ◽  
Wendan Chen ◽  
Minting Liu ◽  
...  

Abstract Purpose Due to the prognosis of circumscribed middle gliomas(CMGs)with H3K27M mutation is still unclear. This study explored the prognostic stratification of (CMGs) with H3K27M mutation.Methods: One hundred and sixty middle gliomas(MGs)were identified over 10 years. Immunohistochemistry was done for H3K27M, ATRX, IDH1, and P53, and Sanger sequencing performed for IDH and H3 genes. The clinicopathological characteristics were reviewed and survival analysis performed.Results: 1. H3K27M mutation was associated with a poor prognosis (p = 0.00017) for brainstem gliomas, but not for thalamic gliomas (p = 0.3). In the elder adults (≥40 years), there was no correlation between H3K27M mutation and the prognosis for MGs (p = 0.49).2. For H3K27M mutant MGs, there was no difference in prognosis between diffuse midline gliomas (DMGs) and CMGs (p = 0.211), also between the CNS WHO grades.3. The prognosis of H3K27M mutant CMGs of CNS WHO grade 1 was worse than that of H3K27M wild-type CMGs (p = 0.0024), even worse than of DMGs without H3K27M mutation of CNS WHO grade 2(p = 0.0066). There was no significant difference in prognosis from DMGs with histological grades CNS WHO grade 3 and 4 (p = 0.46).Conclusions: The weight value of H3K27M affecting prognosis is affected by location and age. CMGs with H3K27M mutation have biological behavior similar to high-grade gliomas. It is recommended that Treatment management was referenced to high-grade glioma for CMGs with H3K27 mutation.


2018 ◽  
Vol 75 (5) ◽  
pp. 487-495
Author(s):  
Milan Erdoglija ◽  
Ugljesa Grgurevic ◽  
Snezana Cerovic ◽  
Milena Jovic ◽  
Nenad Baletic ◽  
...  

Background/Aim. Permanent proliferation and periodical infection are the main clinical characteristics of acquired middle ear cholesteatoma. The aim of this study was to research immunohistochemical characteristics of the skin along with the cholesteatoma process in the nearby tissue. This research should influence further studying of etiology and development of acquired middle ear cholesteatoma. Methods. We investigated clinical, histological and immunohistochemical characteristics of cholesteatoma in 50 samples from operated patients with acquired middle ear cholesteatomas. We classified all samples according to their clinical characteristics of cholesteatoma such as bone destruction, presence of infection or cholesteatoma extension and histological characteristics of cholesteatoma such as keratinisation, inflammatory process and extracellular matrix proliferation. We used mouse monoclonal antibodies for proliferating cell nuclear antigen (MAbs for PCNA), Ki-67, COX-2, CD 4 and CD 8 lymphocytes to investigate the expression of those characteristics in the cholesteatoma and in the control skin tissue. Statistical analyses were performed using SPSS for Windows version 16.0 (SPSS, Chicago, IL, USA). We used the independent group t-test, Spearman?s correlation analysis and Mann-Whitney U test to analyze statistical analysis. Results. Expression of PCNA, Ki-67, COX-2 and CD 8 lymphocytes in more serious clinical picture of cholesteatoma was almost equal as in less serious clinical picture of cholesteatoma. There was statistically significantly higher concentration of inflammation marker CD 4 lymphocytes, both in the acquired cholesteatoma and in the skin of bony portion of the external auditory canal near fibrocartilaginous annulus in more serious clinical picture of cholesteatoma than in less serious clinical picture of cholesteatoma (p < 0.01). There was statistically significant difference of expression of PCNA, Ki- 67, COX-2, CD 4 and CD 8 lymphocytes between all cholesteatoma samples and the skin of bony portion of the external auditory canal (p < 0.05) and statistically significant difference of expression of those markers between the skin of bony portion of the external auditory canal and retroauricular skin (p < 0.05). Conclusion. Inflammation of the skin of bony portion of the external auditory canal is a milestone in pathogenesis of acquired middle ear cholesteatoma. Expression of CD 4 lymphocytes can be the prognostic factor for acquired cholesteatoma clinical picture development. We found so much diversity in biological behavior through very different levels of cholesteatoma development. Expression of Ki-67 in acquired middle ear cholesteatoma is a reliable and stable marker of proliferation for acquired middle ear cholesteatoma.


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