Expression of Progestrone Receptor and Proliferative Marker ki 67, in Various Grades of Meningioma

  • Nasrin Shayanfar Mail Department of Pathology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
  • Masoud Mashayekh Department of Pathology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
  • Masoud Mohammadpour Department of Pediatric, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Meningioma, receptors, progesterone, mitotic index, Ki-67 antigen


Meningiomas are slow-growing neoplasms which recur locally, their morphologic grading is simple but do not always correlate with patient outcome. The aim of present study is to evaluate the status of progesterone receptor (PR) and proliferation marker Ki67 in various grades of meningioma in a group of Iranian patients. 78 cases of meningioma were selected from the file of a hospital university. All archival H&E stained sections were reviewed and regraded according to WHO criteria. Immunohistochemical analysis for PR and Ki67 was performed on formalin- fixed, paraffin- embedded samples. PR status considered positive if > 10% of tumor cell’s nuclei were strongly immunoreactive, or if > 50% of nuclei were stained with medium intensity. The Ki67 labeling index (LI) is defined as the percentage area with strongest immunostaining. PR were positive in 61/63(96.8%) of grade I tumors,2/10(20%) of grade II,and 0/5(0%) of grade III tumors.Ki67 LI was %2.98±2.27 in grade I tumors, %9.30±5.79 in grade II tumors and %34.00±5.47 in grade III tumors. For both markers, differences between grade I,II and III tumors were significant(P<0.001).There was a reverse relationship between mean of Ki67 LI and PR status,with increasing grade of tumor. Evaluation of PR status and Ki67 LI together with conventional histologic evaluation can help in providing more information about the biologic behaviour of meningiomas,especially for those that histological grading is not straightforward.


Marosi C, Hassler M, Roessler K, Reni M, Sant M, Mazza E, et al. Meningioma. Crit Rev Oncol Hematol 2008;67(2):153-71.

Louis DN, Scheithauer BW, Budka H, Von Deimling A, Kepes JJ. Meningiomas. In: Kleihues P, Cavenee WK, editors. Pathology and Genetics. Tumors of the Nervous System, WHO Classification of Tumors. Lyon: IARC Press; 2000. p. 176-84.

Black PM. Meningiomas. Neurosurgery 1993;32(4):643-57.

Hsu DW, Pardo FS, Efird JT, Linggood RM, Hedley-Whyte ET. Prognostic significance of proliferative indices in meningiomas. J Neuropathol Exp Neurol 1994;53(3):247-55.

Skender-Gazibara M, Cvetković-Dožić D, Dožić S, Govedarović V. Value of the proliferative and hormonal markers in estimation of biological behaviour of meningioma. Arch Oncol 2002;10(3):182-3.

Kleihues P, Burger PC, Scheithauer BW, editors. Histological Typing of Tumors of The Central Nervous System. 2nd ed. Geneva, Switzerland: World Health Organization; 1993.

Zulch KJ, editor. International Histological Classification of Tumors. Histological Typing of Tumors of the Central Nervous System. No. 21. Geneva, Switzerland: World Health Organization; 1979.

Miller DC, Ojemann RG, Proppe KH, McGinnis BD, Grillo HC. Benign metastasizing meningioma. J Neurosurg 1985;62:763–6.

Jääskeläinen J, Haltia M, Laasonen E, Wahlström T, Valtonen S. The growth rate of intracranial meningiomas and its relation to histology. An analysis of 43 patients. Surg Neurol 1985;24(2):165-72.

Jääskeläinen J, Haltia M, Servo A. Atypical and anaplastic meningiomas: radiology, surgery, radiotherapy, and outcome. Surg Neurol 1986;25(3):233-42.

de la Monte SM, Flickinger J, Linggood RM. Histopathologic features predicting recurrence of meningiomas following subtotal resection. Am J Surg Pathol 1986;10(12):836-43.

Maier H, Ofner D, Hittmair A, Kitz K, Budka H. Classic, atypical, and anaplastic meningioma: three histopathological subtypes of clinical relevance. J Neurosurg 1992;77(4):616-23.

Burger PC, Scheithauer BW. Tumors of the central nervous system. In: Rosai J, editor. Atlas of Tumor Pathology. 3rd series, fascicle 10. Washington, DC: Armed Forces Institute of Pathology; 1994. p. 259-86.

Miller DC. Predicting recurrence of intracranial meningiomas. A multivariate clinicopathologic model-- interim report of the New York University Medical Center Meningioma Project. Neurosurg Clin N Am 1994;5(2):193-200.

Perry A, Scheithauer BW, Stafford SL, Lohse CM, Wollan PC. "Malignancy" in meningiomas: a clinicopathologic study of 116 patients, with grading implications. Cancer 1999;85(9):2046-56.

Abramovich CM, Prayson RA. Histopathologic features and MIB-1 labeling indices in recurrent and nonrecurrent meningiomas. Arch Pathol Lab Med 1999;123(9):793-800.

Ho DM, Hsu CY, Ting LT, Chiang H. Histopathology and MIB-1 labeling index predicted recurrence of meningiomas: a proposal of diagnostic criteria for patients with atypical meningioma. Cancer 2002;94(5):1538-47.

Louis DN, Budka H, von Deimling A. Meningiomas. In: Kleihues P, Cavenee WK, editors. Pathology and Genetics of Tumours of the Nervous System. Lyon: IARC Press; 2000. p. 134-41.

Gursan N, Gundogdu C, Albayrak A, Kabalar ME. Immunohistochemical detection of progesterone receptors and the correlation with Ki-67 labeling indices in paraffinembedded sections of meningiomas. Int J Neurosci 2002;112(4):463-70.

Strik HM, Strobelt I, Pietsch-Breitfeld B, Iglesias-Rozas JR, Will B, Meyermann R. The impact of progesterone receptor expression on relapse in the long-term clinical course of 93 benign meningiomas. In Vivo 2002;16(4):265-70.

Blankenstein MA, Verheijen FM, Jacobs JM, Donker TH, van Duijnhoven MW, Thijssen JH. Occurrence, regulation, and significance of progesterone receptors in human meningioma. Steroids 2000;65(10-11):795-800.

Fewings PE, Battersby RD, Timperley WR. Long-term follow up of progesterone receptor status in benign meningioma: a prognostic indicator of recurrence? J Neurosurg 2000;92(3):401-5.

Nagashima G, Aoyagi M, Wakimoto H, Tamaki M, Ohno K, Hirakawa K. Immunohistochemical detection of progesterone receptors and the correlation with Ki-67 labeling indices in paraffin-embedded sections of meningiomas. Neurosurgery 1995;37(3):478-82; discussion 483.

Perrot-Applanat M, Groyer-Picard MT, Kujas M. Immunocytochemical study of progesterone receptor in human meningioma. Acta Neurochir (Wien) 1992;115(1-2):20-30.

Markwalder TM, Gerber HA, Waelti E, Schaffner T, Markwalder RV. Hormonotherapy of meningiomas with medroxyprogesterone acetate. Immunohistochemical demonstration of the effect of medroxyprogesterone acetate on growth fractions of meningioma cells using the monoclonal antibody Ki-67. Surg Neurol 1988;30(2):97-101.

Hsu DW, Efird JT, Hedley-Whyte ET. Progesterone and estrogen receptors in meningiomas: prognostic considerations. J Neurosurg 1997;86(1):113-20.

Maiuri F, De Caro Mdel B, Esposito F, Cappabianca P, Strazzullo V, Pettinato G, et al. Recurrences of meningiomas: predictive value of pathological features and hormonal and growth factors. J Neurooncol 2007;82(1):63-8.

Whittle IR, Foo MS, Besser M, Vanderfield GK. Progesterone and oestrogen receptors in meningiomas: biochemical and clinicopathological considerations. Aust N Z J Surg 1984;54(4):325-30.

Cahill DW, Bashirelahi N, Solomon LW, Dalton T, Salcman M, Ducker TB. Estrogen and progesterone receptors in meningiomas. J Neurosurg 1984;60(5):985-93.

Brandis A, Mirzai S, Tatagiba M, Walter GF, Samii M, Ostertag H. Immunohistochemical detection of female sex hormone receptors in meningiomas: correlation with clinical and histological features. Neurosurgery 1993;33(2):212-7.

Magdelenat H, Pertuiset BF, Poisson M, Martin PM,Philippon J, Pertuiset B, et al. Progestin and oestrogen receptors in meningiomas. Biochemical characterization, clinical and pathological correlations in 42 cases. Acta Neurochir (Wien) 1982;64(3-4):199-213.

Roser F, Nakamura M, Bellinzona M, Rosahl SK, Ostertag H, Samii M. The prognostic value of progesterone receptor status in meningiomas. J Clin Pathol 2004;57(10):1033-7.

Wolfsberger S, Doostkam S, Boecher-Schwarz HG, Roessler K, van Trotsenburg M, Hainfellner JA, et al. Progesterone-receptor index in meningiomas: correlation with clinico-pathological parameters and review of the literature. Neurosurg Rev 2004;27(4):238-45.

How to Cite
Shayanfar N, Mashayekh M, Mohammadpour M. Expression of Progestrone Receptor and Proliferative Marker ki 67, in Various Grades of Meningioma. Acta Med Iran. 48(3):142-147.