DNA repair and cell synthesis proteins: immunohistochemical expression and correlation with recurrence-regrowth in meningiomas.

Meningiomas are considered the second most common neoplasm of the central nervous system in adults. Most of them are benign with slow growth, frequent in women and with a high recurrence rate. In tumors, DNA error repair processes lose efficacy, providing mutagenesis and genomic instability. This work evaluated the expression of proteins involved in cell synthesis (cyclin D1) and DNA errors repair (MUTYH, XPF, XPG) in meningiomas, relating them to clinical, tumor and survival variables. The study included 85 patients, with a mean age of 52 ± 13.3 years and most of them women (2:1 ratio). Sixty-seven cases were grade I (79%). Grade II tumors were independent predictors of recurrence-regrowth (HR: 2.8; p = 0.038). The high expression of cyclin D1 was associated with grade II (p = 0.001) and low MUTYH expression with grade I (p = 0.04). Strong expression of XPF and XPG was associated with grade II (p = 0.002; p < 0.001) and with recurrence-regrowth (p = 0.04; p = 0.003). Strong XPF expression was significantly related to large tumors (p = 0.03). An association of cyclin D1, MUTYH and XPF were found. Survival was not associated with the expression of any of the proteins studied. To know the role of DNA repair proteins and cell synthesis is important for understanding the processes of origin and tumor development. Grade II meningiomas and strong expression of XPF and XPG were predictors of recurrence or regrowth and may assist in clinical management, considering the high recurrence of meningiomas and the absence of consensus regarding treatment.

Immunohistochemical expression of aromatase and estrogen, androgen and progesterone receptors in normal and neoplastic human meningeal cells.

Evidence suggests that sex hormones may play a role in the tumorigenesis of meningiomas, and studies have demonstrated the expression of hormone receptors in these tumors. Aromatase expression has been detected in several normal tissues, including neurons in the CNS, and tumor tissues. We aim to assess the expression of aromatase (ARO) and of progesterone receptor (PR), estrogen receptor (ER) and androgen receptor (AR) in both normal and neoplastic meningeal cells. A cross-sectional study was conducted with 126 patients diagnosed with meningioma (97 women and 29 men; mean age, 53.6 years) submitted to neurosurgery at Hospital São José, Complexo Hospitalar Santa Casa de Porto Alegre, southern Brazil. Control sections of normal meningeal cells, 19 patients, were obtained by evaluating the arachnoid tissue present in the arachnoid cyst resected material. Immunohistochemistry was applied to assess ARO, PR, ER and AR. Aromatase expression was detected in 100% of the control patients and in 0% of the patients with meningioma. ER was present in 24.6% of the meningiomas and in 0% of the controls, AR in 18.3% of the meningiomas and in 0% of the controls, and PR in 60.3% of the meningiomas and in 47.4% of the controls. A positive association was observed between the presence of AR and ER (OR 3.7; P = 0.01) in meningiomas. There were no significant differences in the presence of hormone receptors between meningioma histological subtypes. PR expression in women with meningioma was significantly higher than that found in men (OR 2.3; P = 0.08). Behavior pattern differences observed between aromatase expression, present in normal tissues and absent in meningiomas, and estrogen and androgen hormone receptors, absent in normal tissues and present in meningiomas, suggest that there is heterogeneity in modulation by sex steroids in the development of these tumors.

Espectro de manifestaçöes clínicas, eletrograficas e de neuroimagem em pacientes com provável epilepsia de lobo frontal / Spectrum of clinical manifestations, electrographic and of neuroimaging in patients with suspected frontal lobe epilepsy

A localizaçäo de geradores de descargas epilépticas ictais e inter-ictais nos lobos frontais constitui um desafio ao epileptologista, em funçäo de diversas particularidades anatômicas e neurofisiológicas destas regiöes cerebrais. O presente estudo analisa o espectro de manifestaçöes clínicas, eletrográficas e de neuro-imagem que permitem a suspeita de epilepsia do lobo frontal, a paritr de dados obtidos em 12 pacientes. Apenas 1 paciente demonstrou atividade epiléptica inter-ictal localizada sistematicamente em um lobo frontal. Todos os demais apresentaram extensos focos epilépticos, seja bi-frontais, seja fronto-têmporo-parietais, uni ou bi-lateralmente. O registro das crises habituais dos pacientes näo aportou melhores dados localizados. Entretanto, atividade ictal ao EEG, sem manifestaçöes clínicas aparentes (crise eletrográfica), foi registrada em 6 pacientes, sendo localizatória em 50 por cento . Exames de neuroimagem por ressonância magnética localizaram lesöes epileptógenas em 50 por cento dos casos nos quais este exame foi realizado. O conjunto dos dados sugere que uma suspeita de epilepsia de lobo frontal somente pode ser levantada a partir da análise global de todas as informaçöes disponíveis durante a investigaçäo e em bases individuais