Prognostic importance of progesterone receptor expression in meningioma

Aim: : In this study, our objective was to demonstrate the relationship of progesterone receptor (PR) expression with histologicalgrade and other prognostic factors in patients with meningiomas.Material and Methods: Brain biopsy materials, which were examined and diagnosed with meningioma between January 2011 andJanuary 2015, were screened in a retrospective study design. Ninety-six of the cases, who were diagnosed with meningioma with agrade of I, II, and III according to WHO and had undergone immunohistochemically PR expression, were included in the study.Results: JThere was a weak correlation between WHO grade and PR expression rate and intensity in our study. PRexpression rate and intensity showed increment as the grade progressed. On the other hand, there was no correlationof PR expression rate and intensity with other prognostic parameters such as Ki67 proliferation index and mitotic index.Conclusion: Although we have detected a weak correlation between PR expression rate and intensity with WHO grade, we thinkthat PR expression rate and intensity do not have prognostic role in the meningiomas due to the absence of a similar relationshipbetween other important parameters in prognosis. In most of the studies in the literature, it is reported that PR expression rate andintensity decreases with increasing WHO grade. However, the number of studies with the opposite results is high. In the presence ofconflicting data in the literature and considering that almost all of these studies were performed according to the WHO classificationbefore 2016 (before the new WHO classification), we concluded that further multi-centre studies utilizing new classification systemand have more homogeneous distribution of the grades are required to investigate the relationship between PR and histopathologicgrade and other prognostic parameters.

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1. Wiemels J, Wrensch M, Claus EB. Epidemiology and etiology of meningioma. J Neurooncol 2010; 99 :307- 14.
2. Mukherjee S, Ghosh SN, Chatterjee U, et al. Detection of progesterone receptor and the correlation with Ki67 labeling index in meningiomas. Neurol India 2011; 59:817-22.
3. Surawicz TS, McCarthy BJ, Kupelian V, et al. Descriptive epidemiology of primary brain and CNS tumors: results from the Central Brain Tumor Registry of the United States, 1990-1994. Neuro Oncol 1999; 1:14-25.
4. Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 2016;131:803-20.
5. Backer-Grondahl T, Moen BH, Torp SH. The histopathological spectrum of human meningiomas. Int J Clin Exp Pathol 2012;5:231-42.
6. Shaikh N, Dixit K, Raizer J. Recent advances in managing/understanding meningioma. F1000 Res 2018;7:490.
7. Perry A, Cai DX, Scheithauer BW, et al. Merlin, DAL-1, and progesterone receptor expression in clinicopathologic subsets of meningioma: a correlative immunohistochemical study of 175 cases. J Neuropathol Exp Neurol 2000;59:872-9.
8. Fakhrjou A, Meshkini A, Shadrvan S. Status of Ki67, estrogen and progesterone receptors in various subtypes of intracranial meningiomas. Pak J Biol Sci 2012;15:530-5.
9. Ikeri NZ, Anunobi CC, Bankole OB. Progesterone receptor expression and Ki-67 labelling index of meningiomas in the Lagos university teaching hospital. Niger Postgrad Med J 2018;25:17-20.
10. Khalid H. Immunohistochemical study of estrogen receptor-related antigen, progesterone and estrogen receptors in human intracranial meningiomas. Cancer 1994;74:679-85.
11. Perrot-Applanat M, Groyer-Picard MT, Kujas M. Immunocytochemical study of progesterone receptor in human meningioma. Acta Neurochir 1992;115:20- 30.
12. Hsu DW, Efird JT, Hedley-Whyte ET. Progesterone and estrogen receptors in meningiomas: prognostic considerations. J Neurosurg Spine 1997;86:113-20.
13. Carroll RS, Glowacka D, Dashner K, et al. Progesterone receptor expression in meningiomas.Cancer Res 1993;53:1312-6.
14. Schrell UM, Adams EF, Fahlbusch R, et al. Hormonal dependency of cerebral meningiomas. Part 1: Female sex steroid receptors and their significance as specific markers for adjuvant medical therapy. Acta Neurochir Suppl 1990;73:743-9.
15. Roser F, Nakamura M, Bellinzona M, et al. The prognostic value of progesterone receptor status in meningiomas. J Clin Pathol 2004;57:1033-7.
16. Nagashima G, Aoyagi M, Wakimoto H, et al. Immunohistochemical detection of progesterone receptors and the correlation with Ki-67 labeling indices in paraffin-embedded sections of meningiomas. Neurosurgery 1995;37:478-82.
17. Markwalder TM, Zava DT, Goldhirsch A, et al. Estrogen and progesterone receptors in meningiomas in relation to clinical and pathologic features. Surg Neurol 1983;20:42-7.
18. Korhonen K, Salminen T, Raitanen J, et al. Female predominance in meningiomas can not be explained by differences in progesterone, estrogen, or androgen receptor expression. J Neurooncol 2006;80:1-7.
19. Iplikcioglu AC, Hatiboglu MA, Ozek E, et al. Is progesteron receptor status really a prognostic factor for intracranial meningiomas? Clin Neurol Neurosurg 2014;124:119-22.
20. Spille DC, Hess K, Sauerland C, et al. Brain Invasion in Meningiomas: Incidence and Correlations with Clinical Variables and Prognosis. World Neurosurg 2016;93:346-54.
21. Wolfsberger S, Doostkam S, Boecher-Schwarz HG, et al. Progesterone-receptor index in meningiomas: correlation with clinico-pathological parameters and review of the literature. Neurosurg Rev 2004;27:238- 45.
22. Markwalder TM, Markwalder RV, Zava DT. Estrogen and progestin receptors in meningiomas: clinicopathological correlations. Clin Neuropharmacol 1984;7:368-74.