Artikel
Spinal meningiomas and their recurrences on the basis of their cytogenetic karyotypes
Spinale Meningeome und ihre Rezidivrate basierend auf dem zytogenetischen Karyotyp
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Veröffentlicht: | 11. April 2007 |
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Gliederung
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Objective: Meningiomas are mostly benign tumours that originate from the coverings of brain and spinal cord. They reveal a normal karyotype or, typically, a monosomy for chromosome 22. The rare clinical progression of meningiomas is associated with a non-random pattern of secondary losses of other autosomes. Deletion of the short arm of one chromosome 1 appears to be the decisive step for anaplastic growth in meningiomas.
Methods: We calculated an oncogenetic tree mixture model for explaining the cytogenetic pathways of 661 meningioma patients with respect to localization, progression and recurrence of the tumor. The mixture model estimates typical pathogenetic routes in terms of the accumulation of somatic chromosome changes in tumor cells. The model provides a genetic progression score (GPS) that estimates the genetic status of a tumor.
Results: A correlation between the individual cytogenetic changes and the meningioma location was highly significant [p<10-8]. Except for one case, it was shown that the 49 spinal tumors belonged to the groups not associated with progression [GPS groups 0 and 1]. To assess the varying distribution of the localization in relation to cytogenetic grouping, we decided to distinguish three locations: the spine, the skull base and the convexity including parasagittal region. 30 of the 251 meningiomas of the convexity belonged to the progression-associated groups [GPS group 2], whereas only 11 of 278 meningiomas of the skull base have a genetic progression score higher than 6.39.
Conclusions: The cytogenetic classification of meningiomas provides a significant contribution to the predictability of tumor recurrence and is therefore a valuable criterion for the postoperative management protocol.