SELLAR AND PARASELLAR MENINGIOMAS - CLINICOPATHOLOGICAL FEATURES AND IMMUNOHISTOCHEMICAL PREDICTORS OF TUMOR GRADE
DOI:
https://doi.org/10.22551/MSJ.2026.02.12Abstract
Sellar and parasellar meningiomas (spMs) represent a rare but clinically challenging subgroup of intracranial tumors due to their proximity to critical neurovascular and endocrine structures. This study aimed to provide a comprehensive clinicopathological and statistical evaluation of spMs, with particular emphasis on biological markers associated with tumor aggressiveness. Materials and methods: We retrospectively analyzed 15 patients with histologically confirmed spMs treated surgically at Prof. Dr. N. Oblu Emergency Clinical Hospital, Iași, between 2021 and 2025. Demographical, clinical, radiological, surgical, and immunohistochemical data [Ki-67 labeling index (Ki67 LI), progesterone receptor (PR), and p53 expression] were evaluated. Statistical analysis included comparative tests and logistic regression modeling for predictors of WHO grade. Results: The cohort showed a marked female predominance (80%), with a mean age of 60.3 ± 13.2 years. Most tumors originated in the sellar region (66.7%). Gross total resection was achieved in 66.7% of cases. Histopathologically, WHO grade 1 spMs predominated (73.3%), while grade 2 spMs accounted for 26.7%. Ki-67 LI values were significantly higher in grade 2 tumors (12.0 ± 2.2 vs. 3.4 ± 1.3; p=0.003), whereas PR expression was significantly reduced (42.5 ± 18.9 vs. 81.4 ± 14.8; p=0.010). Logistic regression identified Ki-67 LI (OR=1.85) as an independent risk factor and PR (OR=0.92) as a protective factor for higher tumor grade. Conclusions: These findings highlight the central role of tumor biology in sellar and parasellar meningiomas. Ki-67 LI and PR expression represent complementary and clinically relevant biomarkers that improve risk stratification and may guide surgical and postoperative management.
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