A potential role of ki 67, pr and vegf in determining the tumour behavior of meningiomas

Background: Meningiomas are traditionally considered as benign tumours with an aggressive potential. Utilization of markers for proliferation and neoangiogenesis in combination with hormone receptor study can aid in the identification of a subset of biologically aggressive and morphologically benign tumours. Aim: The study aims at determining the potential role of Ki 67, PR and VEGF in assessing the tumour behavior. Material and Method: This observational study included 50 patients who underwent surgery for meningioma at our hospital during the period of February 2016 to July 2017. Formalin fixed paraffin embedded blocks were prepared and subjected to hematoxylin and eosin staining. Immunohistochemical staining was done for Ki-67, PR, VEGF and CD34 using standard immunoperoxidase techniques. Results: Ki 67 LI was higher in males as compared to females, in grade II and grade III as compared to grade I, in recurrent cases as compared to nonrecurrent cases and in PR negative cases as compared to PR positive ones. VEGF was also strongly expressed in high grade and recurrent meningiomas. However, few cases of grade I meningiomas revealed a stronger VEGF expression and a higher Ki67 LI as compared to the conventional grade I meningiomas, probably due to the increased likelihood of future recurrence and malignancy in such cases. Conclusion: Ki 67 and PR bear an inverse correlation with respect to the grading of meningiomas. Further, VEGF also has a potential role in assessing the aggressiveness of meningiomas and in instituting targeted management of meningiomas.