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Review paper

Morphometric and Ki-67 proliferative index-related characteristics of meningiomas and their correlation with demographic, clinical, histopathological, and postoperative features

By
Ragib Pugonja Orcid logo ,
Ragib Pugonja

Department of General Medicine, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

Department of Anatomy, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

Hakija Bečulić ,
Hakija Bečulić

Department of Anatomy, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

Department of Neurosurgery, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Emir Begagić ,
Emir Begagić
Contact Emir Begagić

Department of General Medicine, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

Rasim Skomorac ,
Rasim Skomorac

Department of Neurosurgery, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Department of Surgery, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

Edin Selimović ,
Edin Selimović

Department of Surgery, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

Primary Healthcare Centre Zenica, Zenica, Bosnia and Herzegovina

Mirza Moranjkić
Mirza Moranjkić

Clinic of Neurosurgery, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina

Abstract

Aim
To investigate the correlations between tumour characteristics, symptoms, intraoperative findings, and outcomes in patient
with meningioma.
Methods
A retrospective study was conducted on 86 surgically treated patients at Department of Neurosurgery of Cantonal Hospital Zenica from 2010 to 2020. Patients with intracranial meningiomas underwent neurological evaluation and MRI scans to analyse tumour characteristics, including volume (TV), peritumoral brain oedema (PTBE) and oedema index (EI). Surgical treatment was performed, followed by postoperative MRI and outcome assessment. Intraoperatively, the tumour’s relationship with cortex, pial membrane, skull bones, and sinuses was evaluated, and the extent of tumour resection was graded. Meningioma samples underwent histopathological analysis to assess the grade and regularity of borders, and Ki-67 labelling index was determined using
immunohistochemistry.
Results
Significant correlations were found between PTBE and Ki67 expression (p<0.001), PTBE and vomiting/nausea (p=0.002), cognitive impairment (p=0.047), venous compression (p=0.001), cortical, pial and dural invasion (p<0.05), and the postoperative presence of oedema (p=0.002). Venous compression, cortical, pial, dural and bone invasion positively correlated with Ki-67 expression (p<0.001). Grade and tumour border positively correlated with Ki-67 expression (p<0.001). Oedema persistence postoperatively showed a positive correlation with Ki-67 expression (p<0.001).
Conclusion
The study revealed significant correlations between Ki-67 expression and PTBE, with notable associations with clinical symptoms, tumour characteristics, and postoperative oedema presence.

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