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The immunohistochemical expression of SSTR2A is an independent prognostic factor in meningioma
Authors:Fodi  Christina  Skardelly  Marco  Hempel  Johann-Martin  Hoffmann   Elgin  Castaneda   Salvador  Tabatabai   Ghazaleh  Honegger   Jürgen  Tatagiba   Marcos  Schittenhelm   Jens  Behling   Felix
Affiliation:1.Department of Neurosurgery, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Hoppe-Seyler Street 3, Tübingen, Germany
;2.Center for CNS Tumors, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany
;3.Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany
;4.Department of Radiation-Oncology, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany
;5.Department of Nuclear Medicine, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany
;6.Department of Neurology & Interdisciplinary Neuro-Oncology, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany
;7.Hertie Institute for Clinical Brain Research, Tübingen, Germany
;8.German Cancer Consortium (DKTK), DKFZ Partner Site Tübingen, Tübingen, Germany
;9.Department of Neuropathology, University Hospital Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany
;
Abstract:

The expression of somatostatin receptors in meningioma is well established. First, suggestions of a prognostic impact of SSTRs in meningioma have been made. However, the knowledge is based on few investigations in small cohorts. We recently analyzed the expression of all five known SSTRs in a large cohort of over 700 meningiomas and demonstrated significant correlations with WHO tumor grade and other clinical characteristics. We therefore expanded our dataset and additionally collected information about radiographic tumor recurrence and progression as well as clinically relevant factors (gender, age, extent of resection, WHO grade, tumor location, adjuvant radiotherapy, neurofibromatosis type 2, primary/recurrent tumor) for a comprehensive prognostic multivariate analysis (n?=?666). The immunohistochemical expression scores of SSTR1, 2A, 3, 4, and 5 were scored using an intensity distribution score ranging from 0 to 12. For recurrence-free progression analysis, a cutoff at an intensity distribution score of 6 was used. Univariate analysis demonstrated a higher rate of tumor recurrence for increased expression scores for SSTR2A, SSTR3, and SSTR4 (p?=?0.0312, p?=?0.0351, and p?=?0.0390, respectively), while high expression levels of SSTR1 showed less frequent tumor recurrences (p?=?0.0012). In the Kaplan–Meier analysis, a higher intensity distribution score showed a favorable prognosis for SSTR1 (p?=?0.0158) and an unfavorable prognosis for SSTR2A (0.0143). The negative prognostic impact of higher SSTR2A expression remained a significant factor in the multivariate analysis (RR 1.69, p?=?0.0060). We conclude that the expression of SSTR2A has an independent prognostic value regarding meningioma recurrence.

Keywords:
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