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. 2024 Jul 1;32(6):292-304.
doi: 10.1097/PAI.0000000000001205. Epub 2024 Jun 12.

Clinicopathological Impact of FOXM1 and MMP-9 Immunohistochemical Expression in Different Grades of Intracranial Meningioma

Hanaa M Ibrahim  1 , Aziza E Abdelrahman  1 , Amira Elwan  2 , Shimaa A Gharieb  2 , Mohammed Refaat  2 , Wael Elmesallamy  3 , Amira A Salem  1
Affiliations

Clinicopathological Impact of FOXM1 and MMP-9 Immunohistochemical Expression in Different Grades of Intracranial Meningioma

Hanaa M Ibrahim et al. Appl Immunohistochem Mol Morphol. .

Abstract

Objectives: To find predictive biomarkers for recurrence and progression of meningioma.

Background: Despite great advances in meningioma treatment, the prognosis remained unfavorable due to the high recurrence rate.

Methods: In this study, we evaluated the immunohistochemical expression of FOXM1, MMP-9, and Ki67 in 50 cases of intracranial meningioma to detect its potential role in meningioma progression, recurrence, and patients' survival.

Results: Strong FOXM1 expression was detected in 20% of the cases and was significantly associated with meningioma grade ( P = 0.002) and peritumoral brain edema (PTBE; P <0.001). Strong MMP-9 expression was noted in 32% of the cases and was significantly associated with meningioma grade and PTBE ( P <0.001, P <0.001, respectively). High Ki67 was noted in 50% and significantly associated with tumor grade and PTBE ( P <0.001, P = 0.002, respectively). The follow-up period revealed that meningiomas with strong FOXM1, strong MMP-9, and high Ki67 expression were associated with tumor recurrence, shorter OS, and recurrence-free survival. Furthermore, up-regulation of FOXM1 and MMP-9 expression had a significant relation with poor clinical response to the therapy ( P = 0.010, P = 0. 001, respectively). However, high Ki67 cases were more sensitive to clinical therapy ( P = 0.005).

Conclusion: Strong FOXM1, strong MMP-9, and high Ki67 in meningiomas indicate highly aggressive tumors with a shortened survival rate, dismal outcome, and high risk of recurrence after the standard protocol of therapy.

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Conflict of interest statement

The authors declare no conflict of interest.

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