Meningioma Totally Removed The Recurrence And Growth Hormone Receptor, Glucocorticoid Receptor Expression

Objective To explore the expression and significance of growth hormone receptor (GHR) in meningiomas and to analyze the factors related to the recurrence of meningiomas after complete gross resection in order to give evidence for the prediction and prevention of recurrence.Methods GHR and PCNA (proliferating cell nuclear antigen) of 60 meningioma specimens were detected by immunohistochemistry and their apoptosis was detected by TUNEL. PCNA labeling indices (PCNALI) and apoptotic indices (AI) were calculated to quantify PCNA and apoptosis. The expression of GHR was analyzed including the relation between GHR and gender, age, location, histological grade, PCNA and AI. The recurrent meningiomas and non-recurrent ones were compared to analyze their differences in gender, age, location, histological grade, GHR, PCNA and AI.Results When recurrent meningiomas were compared with non-recurrent ones, the gender and age differences were not significant, but the location difference was significant. The percent of Parasagittal or falx meningiomas in recurrent group (52. 0%) was much greater than that in non-recurrent group (13. 6%).In recurrent group 63. 0% belonged to grade Ⅱ ~ Ⅲ , but in non-recurrent group the percent of grade Ⅱ ~Ⅲ was only 6. 1%, and both were significantly different. PCNA was detected in all meningioma samples in which 6 meningiomas were " +", 15 were "++", 33 were "+++" and 6 were "++++" . The mean PCNALI was 54.2% ±20.4%. The expression level of PCNA and PCNALI of grade Ⅱ ~ Ⅲ meningiomas were significantly higher than that of grade Ⅰ . However the PCNALI of meningothelial, fibroblastic and transitional subtypes were not different. The expression level of PCNA and PCNALI in recurrent group were significantly higher than that in non-recurrent group. The PCNALI of the former was 63. 0%± 15. 3% and the latter was 47.0%±21.4%. Apoptotic cells were detected in 88. 3% meningiomas by TUNEL. The mean AI of 60 meningiomas was 0. 17% ± 0. 11%. The AI of grade Ⅱ ~ Ⅲ meningiomas was significantly higher than that of grade Ⅰ . The difference in AI of meningothelial, fibroblastic and transitional meningiomas was not significant. The AI of recurrent group (0. 23%±0. 10%) was also significantly greater than that of non-recurrent group (0. 11%± 0. 09%). There was a positive correlation between PCNALI and AI. In 60 meningiomas 19 were GHR-positive, 41 were GHR-negative, and the positive rate was 31.7%. The cytoplasm of GHR-positive cells was stained and the nuclei were not stained. The staining intensity was weak. The distribution of positive cells in meningiomas was focal and heterogeneous. The vascular endothelial cells in meningiomas were GHR-negative. The GHR-positive rate of male was significantly higher than that of female. The expression of GHR had no relation to age and location. There was no significant difference in GHR-positive rate between grade I meningiomas and grade Ⅱ ~ Ⅲ meningiomas. The differences in the expression level of PCNA, PCNALI and AI between GHR-positive group andGHR-negative group were not statistically significant. There was no significant difference between the GHR-positive rate of recurrent group and that of non-recurrent group.Conclusion The recurrence of meningiomas after gross total resection has no relation to gender, age and the expression of GHR; however there is close correlation between tumor recurrence and location, pathological nature, proliferative activity and cell apoptosis. Parasagittal or falx meningiomas have greater recurrence tendency because tumor invades the walls and lumen of superior sagittal sinus and it is not easy to get a radical resection of tumor. The risk of tumor recurrence enlarges with the increase in histological grade. The expression of PCNA in meningiomas correlates with histological grade and recurrence. The expression level of PCNA reflects the proliferative activity, pathological nature and invasive biological behavior of meningiomas. Meningiomas with high PCNA level have great tendency of recurrence. There is spontaneous cell apoptosis in meningiomas and apoptosis is an important biological characteristic of meningiomas. Cell apoptosis of meningiomas has relation to not only histological grade but also recurrence. High histological grade is accompanied by increase of apoptotic cells. Detecting apoptosis contributes to the prediction of recurrent possibility. Apoptotic cells of meningiomas increase with the increase in proliferative activity, which implies the balance regulation between proliferation and apoptosis. The low expression rate and low expression level of GHR in meningiomas imply meningioma is probably not the target tissue of growth hormone. The expression of GHR has no relation to the proliferative state reflected by PCNA level. GHR probably has no effect on the proliferation of meningiomas. Only cytoplasmic staining is observed in GHR-positive meningioma cells and thereare no nuclear receptor and nuclear translocation . This implies GHR in meningiomas is possibly not functional. The expression of GHR in meningiomas has no relation to histological grade and prognosis, and detecting GHR is helpless to the prediction of recurrence. Vascular endothelial cells in meningiomas are GHR-negative, which indicates GHR has no effect on angiogenesis of meningiomas. In addition GHR has no influence on apoptosis of meningioma cells.