Study of percentage of population in s-phase in primary meningioma by dna flow cytometry as predictor for recurrence: correlation with clincopathologic prognostic factors

ABSTRACT

Despite the gross total resection of meningiomas, there is a significant rate of recurrence approaching 20% at 20 years. The prediction of recurrence by clinical and histopathological factors are inadequate, Flow cytometric analysis of deoxyribonucleic acid [DNA] in meningiomas has shown a correlation between a high proliferative index based on tumor cell- cycle stage [percentage of S and percentage of G2/M] and clinically aggressive behavior. Accordingly the DNA analysis of meningioma may be of value in predicting recurrence of the tumors. A series of 130 meningiomas with gross total resection were analyzed. All available microscopic slides were reclassified according to the revised World Health Organization system [WHO].Sections were then taken for flow cytometry study. Thirty-eight [29%] of primary meningiomas associated with recurrence. Only strong significant correlation of histological grading, mitotic index and tumor necrosis with recurrence [the recurrence indices were respectively 27% in Gl meningioma, 75% in GII and 100% in GIII meningiomas [p < 0.001]. Mitotic counts were statistically higher in the recurrent group [6.32 +/- 5.44 for recurrent meningioma and 0.51 +/- 0.53 for non-recurrent. The difference between the two groups was statistically significant [p< 0.001], and necrosis was more observed in recurrent meningioma in 15 cases of 27 cases had tumor necrosis. DNA flow cytometry analysis showed that recurrent benign meningiomas had high SPF in comparison with that benign without recurrence. [SPF mean 10.86 +/- 5.5 and 7.35 +/- 2.8 respectively]. In conclusion these results support the suggestion of that flow cytometry may be of value in the prediction of recurrence of histologically benign macsroscopically removed meningiomas