Ho et al identified criteria associated with recurrence of meningiomas. This can help identify patients who may require more aggressive management and closer followup. The authors are from Veterans General Hospital-Taipei and National Yang-Ming University in Taiwan.
Parameters:
(1) histologic architecture of the tumor
(2) number of mitoses
(3) necrosis
(4) MIB-1 labeling index
|
Parameter |
Finding |
Points |
|
histologic architecture |
preserved |
0 |
|
|
lost (presence of sheeting) |
1 |
|
mitotic rate |
< 3 per 10 high powered fields (< 1.5 mitoses per square mm) |
0 |
|
|
>= 3 per 10 high powered fields (>= 1.5 mitoses per square mm) |
1 |
|
necrosis |
absent |
0 |
|
|
present |
1 |
where:
• The mitotic count used was the highest count for 10 high powered fields counted.
total histologic score =
= SUM(points for all 3 parameters)
MIB-1 evaluation:
(1) Evaluation was done with a 10x ocular and 40x objective (total magnification 400x).
(2) From 1,000 to 5,000 cells are counted, excluding vascular and blood cells.
MIB-1 labeling index =
= (number of cells that stain with MIB-1) / (total number of cells in the evaluated area) * 100
Interpretation:
• minimum total histologic score: 0
• maximum histologic total score: 3
• A score of 2 or 3 indicates an atypical meningioma (or worse).
• A score of 0 or 1 indicates a benign meningioma.
|
Group |
10 Year Recurrence Rate |
10 Year Mortality Rate |
|
benign |
1.9% |
0% |
|
atypical |
94% |
27% |
|
MIB-1 Labeling Index |
Risk Group for Recurrence |
Probability of 10 Year Recurrence |
|
< 10% |
low |
0% |
|
>= 10% |
high |
97% |
Specialty: Hematology Oncology, Surgery, general, Neurology
