Immunohistochemical Markers Associated with Meningioma Recurrence: A Systematic Review

Objective: This study aims to know the role of immunohistochemical markers in the recurrence of surgically treated meningiomas. Material and Methods: We conducted a comprehensive search of the PubMed, ScienceDirect, Cochrane Library, and Google Scholar databases to locate studies published within the past decade. The inclusion criteria for this study were patients aged 18 years or older who had undergone surgical treatment for meningioma. Studies that were not written in English, case report studies, case series studies, literature review studies, and studies involving patients who received treatment other than surgery or multimodal therapy were excluded. All studies that met the inclusion criteria were subjected to critical appraisal. Results: Four studies comprising 3176 cases of meningioma cases were included in the analysis. Multivariate analysis showed that two immunohistochemical markers (COX-2 and MIB-1/Ki-67) were independent variables for meningioma recurrence. This study also found no statistical differences between grade I and grade II meningiomas with respect to the overexpression of COX-2 and MIB-1/Ki-67. The second study compared the nonrecurrence/relapse (non-R/R) and recurrence/relapse (R/R) groups and found a significant correlation with MIB-1 percentage, intensity, histoscore, and p53 percentage, regardless of tumor grade. The third study found that mitosin and topoisomerase IIα were significant predictors of recurrence but not MIB-1. The fourth study demonstrated that H3K27me3 loss is significantly associated with more aggressive meningiomas. Conclusion: Our study concluded that MIB-1/Ki-67, COX-2, p53, topoisomerase IIa, mitosin and H3K27 were independent variables and reliable markers in predicting meningioma recurrence.