Immunohistochemical Expression of MUC4 in Different Meningioma Subtypes in Comparison to Some Mesenchymal Non-Meningothelial Tumors

Kareman Mansour; Dalal Anwar Elwi; Sara Elsayed Khalifa; Heba Abdelmonem Ibrahim

doi:10.3889/oamjms.2021.6783

Authors

Kareman Mansour Department of Pathology, Faculty of Medicine, Cairo University, Giza, Egypt https://orcid.org/0000-0003-2940-8280
Dalal Anwar Elwi Department of Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
Sara Elsayed Khalifa Department of Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
Heba Abdelmonem Ibrahim Department of Pathology, Faculty of Medicine, Cairo University, Giza, Egypt

DOI:

https://doi.org/10.3889/oamjms.2021.6783

Keywords:

Meningioma, Mesenchymal tumors, MUC4, Immunohistochemistry

Abstract

BACKGROUND: Meningiomas are the most common primary tumors of the central nervous system worldwide. Routinely used immunohistochemical markers for diagnosis of confusing meningioma cases as epithelial membrane antigen lack specificity and sensitivity. MUC4 is glycosylated membrane-associated mucin expressed by normal epithelia and many cancers. However, it is recently noticed to be expressed in meningiomas.

AIM: Intensity of MUC4 expression is needed to be verified whether it is the same among different subtypes or not.

MATERIALS AND METHODS: Fifty cases of different intracranial meningioma subtypes and thirty cases of mesenchymal nonmeningothelial tumors were immunohistochemically stained with MUC4 antibody. The results of MUC4 expression intensity were associated with some clinical and pathological parameters.

RESULTS: Most studied meningioma cases (84%) showed positive MUC4 expression. Meningothelial meningioma subtype showed characteristic pattern of diffuse and moderate to strong MUC4 staining. While fibroblastic meningioma showed mostly negative staining pattern and focal weak staining pattern if positive. A statistically significant relationship was detected between tumor subtype and intensity of MUC4 expression. On contrary, most included mesenchymal cases were MUC4 negative with statistical significance. Hence, the sensitivity of MUC4 as diagnostic marker for meningioma was 84%, while the specificity was 93.3%. Furthermore, meningioma histologic subtype showed significant relationship with age.

CONCLUSION: The current study results suggest that MUC4 could be used as meningioma diagnostic marker with some limitations. Moreover, meningioma should be included in the differential diagnosis of MUC4 positive tumors.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Louis DN, Perry A, Reifenberger G, Von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization classification of tumors of the central nervous system: A summary. Acta Neuropathol. 2016;131(6):803-20. https://doi.org/10.1007/s00401-016-1545-1 PMid:27157931 DOI: https://doi.org/10.1007/s00401-016-1545-1

Bhala S, Stewart DR, Kennerley V, Petkov VI, Rosenberg PS, Best AF. Incidence of benign meningiomas in the United States: Current and future trends. JNCI Cancer Spectrum. 2021;5(3):35. https://doi.org/10.1093/jncics/pkab035 DOI: https://doi.org/10.1093/jncics/pkab035

Zalata KR, El-Tantawy DA, Abdel-Aziz A, Ibraheim AW, Halaka AH, Gawish HH, et al. Frequency of central nervous system tumors in delta region, Egypt. Indian J Pathol Microbiol. 2011;54(2):299. https://doi.org/10.4103/0377-4929.81607 PMid:21623078 DOI: https://doi.org/10.4103/0377-4929.81607

Choy W, Ampie L, Lamano JB, Kesavabhotla K, Mao Q, Parsa AT, et al. Predictors of recurrence in the management of chordoid meningioma. J Neurooncol. 2016;126(1):107-16. https://doi.org/10.1007/s11060-015-1940-9 PMid:26409888 DOI: https://doi.org/10.1007/s11060-015-1940-9

Louis DN, Ohgaki H, Wiestler OD, Cavenee WK. WHO Classification of Tumors of the Central Nervous System Revised. 4th ed. Lyon, France: International Agency for Research on Cancer; 2016. p. 1-355.

Menke JR, Raleigh DR, Gown AM, Thomas S, Perry A, Tihan T. Somatostatin receptor 2a is a more sensitive diagnostic marker of meningioma than epithelial membrane antigen. Acta Neuropathol. 2015;130(3):441-3. https://doi.org/10.1007/s00401-015-1459-3 PMid:26195322 DOI: https://doi.org/10.1007/s00401-015-1459-3

Hollingsworth MA, Swanson BJ. Mucins in cancer: Protection and control of the cell surface. Nat Rev Cancer. 2004;4(1):45-60. https://doi.org/10.1038/nrc1251 PMid:14681689 DOI: https://doi.org/10.1038/nrc1251

Kaur S, Kumar S, Momi N, Sasson AR, Batra SK. Mucins in pancreatic cancer and its microenvironment. Nat Rev Gastroenterol Hepatol. 2013;10(10):607. https://doi.org/10.1038/nrgastro.2013.120 PMid:23856888 DOI: https://doi.org/10.1038/nrgastro.2013.120

Matsuyama A, Jotatsu M, Uchihashi K, Tsuda Y, Shiba E, Haratake J, et al. MUC 4 expression in meningiomas: Under-recognized immunophenotype particularly in meningothelial and angiomatous subtypes. Histopathology. 2019;74(2):276-83. https://doi.org/10.1111/his.13730 PMid:30112770 DOI: https://doi.org/10.1111/his.13730

de Oliveira Silva CB, Ongaratti BR, Trott G, Haag T, Ferreira NP, Leães CG, et al. Expression of somatostatin receptors (SSTR1- SSTR5) in meningiomas and its clinicopathological significance. Int J Clin Exp Pathol. 2015;8(10):13185. PMid:26722517

Ding Y, Qiu L, Xu Q, Song L, Yang S, Yang T. Relationships between tumor microenvironment and clinicopathological parameters in meningioma. Int J Clin Exp Pathol. 2014;7(10):6973. PMid:25400783

Kato Y, Nishihara H, Mohri H, Kanno H, Kobayashi H, Kimura T, et al. Clinicopathological evaluation of cyclooxygenase-2 expression in meningioma: Immunohistochemical analysis of 76 cases of low and high-grade meningioma. Brain Tumor Pathol. 2014;31(1):23-30. https://doi.org/10.1007/s10014-012-0127-8. PMid:23250387 DOI: https://doi.org/10.1007/s10014-012-0127-8

Ostrom QT, Gittleman H, Truitt G, Boscia A, Kruchko C, Barnholtz-Sloan JS. CBTRUS statistical report: Primary brain and other central nervous system tumors diagnosed in the United States in 2011-2015. Neurooncology. 2018;20(4):1-86. https://doi.org/10.1093/neuonc/noy131 PMid:30445539 DOI: https://doi.org/10.1093/neuonc/noy131

Pierscianek D, Wolf S, Keyvani K, El Hindy N, Stein KP, Sandalcioglu IE, et al. Study of angiogenic signaling pathways in hemangioblastoma. Neuropathology. 2017;37(1):3-11. https://doi.org/10.1111/neup.12316 PMid:27388534 DOI: https://doi.org/10.1111/neup.12316

Chaturvedi P, Singh AP, Batra SK. Structure, evolution, and biology of the MUC4 mucin. FASEB J. 2008;22(4):966-81. https://doi.org/10.1096/fj.07-9673rev PMid:18024835 DOI: https://doi.org/10.1096/fj.07-9673rev

Doyle LA, Möller E, Dal Cin P, Fletcher CD, Mertens F, Hornick JL. MUC4 is a highly sensitive and specific marker for low-grade fibromyxoid sarcoma. Am J Surg Pathol. 2011;35(5):733-41. https://doi.org/10.1097/pas.0b013e318210c268 PMid:21415703 DOI: https://doi.org/10.1097/PAS.0b013e318210c268

Doyle LA, Wang WL, Dal Cin P, Lopez-Terrada D, Mertens F, Lazar AJ, et al. MUC4 is a sensitive and extremely useful marker for sclerosing epithelioid fibrosarcoma: Association with FUS gene rearrangement. Am J Surg Pathol. 2012;36(10):1444-51. https://doi.org/10.1097/pas.0b013e3182562bf8 PMid:22982887 DOI: https://doi.org/10.1097/PAS.0b013e3182562bf8