Mitosin, a novel marker of cell proliferation and early recurrence in intracranial meningiomas

A.E. Konstantinidou1, P. Korkolopoulou1, N. Kavantzas1, H. Mahera2, I. Thymara1, X. Kotsiakis3, M. Perdiki1, E. Patsouris1 and P. Davaris1

1Department of Pathology, Medical Faculty, National University of Athens, Greece, 2Department of Pathology, KAT General Hospital, Athens, Greece and 3Division of Neurosurgery, General Hospital of Hania, Greece

Offprint requests to: A.E Konstantinidou, MD, 28, Narkisson str., 152 33 Polydroson, Athens, Greece. Fax: 3010-74 62 157. e-mail: takonst@hol.gr

 

Summary. The expression of mitosin, a novel proliferation-associated molecule was evaluated immunohistochemically in a consecutive series of 47 patients with primary intracranial benign and atypical meningiomas. Mitosin expression was correlated with proliferation markers Ki-67 (MIB-1), proliferating cell nuclear antigen (PCNA), topoisomerase IIa (TopoIIa) and mitotic index, as well as with standard clinicopathological parameters and patient outcome. Seven tumors recurred (14.8%) following gross total resection, within a follow-up period ranging from 21 to 108 months (median 60 months). The higher proliferation indices were obtained with mitosin and PCNA and the lower ones with TopoIIa. Mitosin labeling index (LI) ranged from 0.1 to 57% (median 3%), with a significant overlapping of values between grades. A significant positive correlation was shown between mitosin LI on the one hand and Ki-67 LI (p<0.001), or the mitotic index (p=0.027) on the other. The incidence of recurrence was higher in cases with a mitosin LI higher than 3% (p=0.048). Univariate analysis disclosed mitosin LI (p=0.033) along with the mitotic index (p=0.024) and tumor size (p=0.028) as significant predictors of shortened recurrence-free survival. In multivariate analysis, the labeling indices of mitosin (p=0.035) and Ki-67 (p=0.032), along with tumor size, were shown to provide independent prognostic information, beyond that obtained by standard clinical and pathological parameters. However, as indicated by factor analysis, the prognostic information yielded by mitosin was superior to that provided by the remaining proliferation markers (p=0.041). We conclude that mitosin immunohisto-chemical expression, although failing to discriminate between benign and atypical meningiomas, may be of use as a novel cell proliferation marker and as a predictor of tumor recurrence. Histol. Histopathol. 18, 67-74 (2003)

Key words: Mitosin, Meningiomas, Proliferation, Recurrence, Survival

DOI: 10.14670/HH-18.67