Expression of NF2, TRAF7, PI3KCA, and PGR in Skull Base vs Non- Skull Base Meningiomas: A Quantitative Cross-Sectional Study
Abstract
Objective: Meningiomas exhibit distinct genetic mutations. The association between NF2, TRAF7, PIK3CA, and progesterone receptor (PGR) mutations with tumor location remains elusive. This study aimed to quantify and compare the immunoexpression of these biomarkers across meningioma subtypes.
Material and Methods: A cross-sectional analysis was performed on 70 formalin-fixed paraffin-embedded (FFPE) meningioma tissue samples (35 skull base, 35 non-skull base) from Dr. Arifin Achmad Hospital, Indonesia (2021–2023). Immunohistochemistry assessed NF2, TRAF7, PIK3CA, and PGR expression levels based on predefined cell-positivity thresholds. Tumor location, WHO grade, demographic data, and hormonal contraceptive history were also analyzed.
Results: In patients with skull base meningiomas, 85.7% were categorized as benign, compared to 62.9% in those with non-skull base meningiomas (p-value<0.020). The immunohistochemical expression levels of NF2, TRAF7, and PIK3CA between the two study groups showed significant differences (p-value<0.001). Skull base meningiomas exhibited a higher expression of NF2, TRAF7, and PIK3CA. This study also demonstrated a positive relationship between the duration of hormonal contraceptive use and the percentage of PGR expression, where longer use of hormonal contraceptives was associated with increased PGR expression in meningiomas (p-value<0.05). There were no significant differences in sex, age, or contraceptive usage prevalence between the groups (p-value>0.05).
Conclusion: Skull base meningiomas demonstrate distinct molecular profiles characterized by NF2 presence and TRAF7/PIK3CA overexpression, suggesting non-NF2 tumorigenesis pathways. Non-skull-base meningiomas frequently lack NF2, correlating with higher malignancy. PGR expression is ubiquitous and linked to hormonal contraceptive duration. These findings support the location-based molecular stratification of meningiomas and the development of targeted therapies for difficult-to-resect tumors.
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