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Vol. 25, Art. 25 (pp. 461-484)    |    2024       

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Prognostic value of ki67/mib1 expression in schwannomas with relapses after gross total resection

Murzaeva D.A.1,2, Perymskaya A.S.2, Dolgushin A.A.1, Orlov A.Y.1, Abukerimova S.K.2, Simonov A.V.4, Sufianov A.A.3, Zabrodskaya Y.M.1,4

1«Polenov Neurosurgical Institute - branch of Almazov National Medical Research Centre», 12, Mayakovskogo st., Saint Petersburg, 191014, Russia
2Federal State Budgetary Educational Institution of Higher Education "Tyumen State Medical University", 54, Odesskaya st., Tyumen, 625023, Russia
3Federal Center of Neurosurgery, 5, 4 km. Chervyshevskogo tracta st., Tyumen, 625062, Russia
4North-Western State Medical University named after I.I. Mechnikov, 41, Kirochnaya st., Saint Petersburg, 191015, Russia

Brief summary

It is said that the most objective criterion for post-operative control of a tumor is the volume of surgical resection. Relapse after total fross resection of schwannoma occurs in 0,05-9,2% of cases, after subtotal resection - 44%. At the same time, other predictive factors of progression of tumors are being sought. The immunohistochemical marker Ki-67 is commonly used in pathology as a predictive marker. At the same time, in tumors of different localizations, thresholds, so-called «cut-off», are described for the delimitation of grade and prognosis, which are not defined for the prediction of relapses schwannomas. The purpose of the study: the detection the «cut-off» of Ki67/MIB1 and the possibility of using this parameter as a criterion for predicting schwannomas relapse in patients after total surgical resection. Materials and Methods. The study included patients who received neurosurgical treatment in the amount of total schwannoma resection. Post-op histological material from 28 women and 13 men was examined. There were 61 slides, including material from 14 patients with no recurrence over the past 10 years, from 20 patients with primary tumor, and from 27 patients with relapse tumor. The ROC curves were used to compare patients with a primary tumor with non-recurrent tumors. Methods of descriptive and non-parametric statistics, ROC-analysis were used. Results. The value of Ki-67 in recurrent tumors was statistically significantly higher in comparison with non-recurrent tumors. The threshold value of Ki-67 at the «cut-off» point in «hot spots» in Antony B or on the whole slide was > 5.5%, in Antony A > 4.5%, the mean values of Ki-67 (at 1 mm2) > 3.5%. With Ki-67 equal to or greater than this value, a high risk of schwannoma relapse is predicted. Sensitivity 84,2%, specificity 71,4% (p<0.001). Conclusion. The proliferative activity index may be used as a potential prognostic marker for schwannoma relapses. Schwannoma progression may be due to both schwann cells and immune cells. Further research is needed to identify potential targets for therapy, as well as to determine thresholds for Ki-67 in other nerve tumors.


Key words

proliferative index; schwannoma; immunohistochemistry; relapses; prognostic criteria

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