1p/14q co-deletion: A determinant of recurrence in histologically benign meningiomas.
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Date
2015-10
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Abstract
Background: Meningiomas are the most common benign central nervous system
tumors. However, a sizeable fraction recurs, irrespective of histological grade.
No molecular marker is available for prediction of recurrence in these tumors.
Materials and Methods: We analyzed recurrent meningiomas with paired parent
and recurrent tumors by fluorescence in situ hybridization for 1p36 and 14q32
deletion, AKT and SMO mutations by sequencing, and immunohistochemistry
for GAB1, progesterone receptor (PR), p53, and MIB-1. Results: 18 recurrent
meningiomas (11 grade I, 3 grade II, 4 grade III) with their parent tumors (14
grade I, 2 grade II and 2 grade III) were identified. Overall, 61% of parent and 78%
of recurrent meningiomas showed 1p/14q co-deletion. Notably, grade I parent
tumors showed 1p/14q co-deletion in 64% cases while 82% of grade I recurrent
tumors were co-deleted. AKT mutation was seen in two cases, in both parent
and recurrent tumors. SMO mutations were absent. GAB1 was immunopositive
in 80% parent and 56.3% recurrent tumors. MIB-1 labeling index (LI), PR and
p53 expression did not appear to have any significant contribution in possible
prediction of recurrence. Conclusion: Identification of 1p/14q co-deletion in a
significant proportion of histologically benign (grade I) meningiomas that recurred
suggests its utility as a marker for prediction of recurrence. It appears to be a
better predictive marker than MIB1-LI, PR and p53 expression. Recognition of
AKT mutation in a subset of meningiomas may help identify patients that may
benefit from PI3K/AKT pathway inhibitors, particularly among those at risk for
development of recurrence, as determined by presence of 1p/14q co-deletion.
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Keywords
1p 14q, AKT, co-deletion, fluorescence in situ hybridization, meningioma, recurrent
Citation
Kakkar Aanchal, Kmar Anupam, Das Amitabha, Pathak Pankaj, Sharma Mehar C, Singh Manmohan, Suri Ashish, Sarkar Chitra, Suri Vaishali. 1p/14q co-deletion: A determinant of recurrence in histologically benign meningiomas. Indian Journal of Pathology & Microbiology. 2015 Oct-Dec 58(4): 433-438.