Prognostic Significance of p53 and p21WAF1/CIP1 Immunoreactivity and Tumor Micronecrosis for Recurrence of Meningiomas |
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Authors: | Kamei Yusuke Watanabe Masatoshi Nakayama Tsuyoshi Kanamaru Kenji Waga Shirou Shiraishi Taizo |
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Affiliation: | (1) Department of Neurosurgery, Mie University School of Medicine, Tsu, Mie, Japan;(2) Second Department of Pathology, Mie University School of Medicine, Tsu, Mie, Japan |
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Abstract: | Recurrence is an important factor for prognosis of meningioma patients, this also occurring with some lesions diagnosed histopathologically as benign. To analyze their relationships with clinicopathological factors, p53 and p21WAF1/CIP1 immunoreactivity, 80 meningiomas were classified into four groups with regard to the World Health Organization (WHO) histological classification and recurrence: 40 cases of Group I (typical type)-NR (no recurrence); five cases of Group I-R (recurrence); 20 cases of Group II (atypical or anaplastic type)-NR and 15 cases of Group II-R.Micronecrosis was detected in 25% of Group II-NR and 73.3% of Group II-R (P=0.007, odds ratio (OR) =8.25, 95% confidence interval (CI) =1.79–38.01). Patients receiving radiation therapy had a lower risk of recurrence (P=0.041, OR =0.20, 95% CI =0.05–0.85). Immunoreactivity for p53 protein was positive in 22% of Group I and 54% or Group II (P=0.005), and in 80% of Group I-R and 15% of Group I-NR (P=0.006, OR = 22.7, 95% CI = 2.15–239.4). p21WAF1/CIP1 protein was detected in 22% of Group I and 48% of Group II (P=0.017), but with no link to recurrence. Multivariate analysis also showed p53 immunoreactivity in Group I (benign lesions) and micronecrosis in Group II (atypical/anaplastic meningiomas) to be strong prognostic factors for recurrence (P<0.05). These results indicate that p53 immunoreactivity and micronecrosis can help predicting recurrence of meningiomas. |
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Keywords: | recurrent meningioma micronecrosis p53 p21WAF1/CIP1 |
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