5 -8 (82) 2025 - Ravshanov D.M., Mavlyanova Z.F., Ashurov R.F. - HISTOPATHOLOGICAL MARKERS OF RECURRENCE RISK OF INTRACRANIAL MENINGIOMAS AND THEIR IMPACT ON THE REHABILITATION POTENTIAL

HISTOPATHOLOGICAL MARKERS OF RECURRENCE RISK OF INTRACRANIAL MENINGIOMAS AND THEIR IMPACT ON THE REHABILITATION POTENTIAL

Ravshanov D.M. - Samarkand State Medical University

Mavlyanova Z.F. - Samarkand State Medical University

Ashurov R.F. - Samarkand State Medical University

Resume

Relapse of intracranial meningiomas remains a serious clinical problem. There is evidence that the proliferative activity of the tumour (Index Ki-67), level of angiogenesis (Microvascular density according to CD34), depth of invasion into the brain tissue and the radicality of surgical resection affect the risk of relapse. The purpose of this study was to quantify the independent effect of these four factors on the early and five-year risk of recurrence after meningioma removal. Research material and methods: 124 patients (average age 56 ± 12 years; 61% women), operated in 2019-2024, were included in prospective observation. The Ki-67 index (immunohistochemistry); microvascular density (CD34), the number of vessels in one field of view (HPF); the depth of invasion into the brain, measured in millimetres (≥ 3 mm was considered significant); the degree of resection according to the Simpson classification (I-II vs. III-V). Relapse was recorded according to the clinic and magnetic resonance imaging. A multidimensional Cox register was used to analyse the risk of early relapse, and logistic regression was used to assess the odds ratio. Results: Ki-67 > 8% was associated with a 5.2-fold increase in the risk of early relapse (hazard ratio HR = 5.2; 95% CI 2.1-12.8; p < 0.001). CD34 > 15 vessels/HPF independently increased the risk by 3.7 times (HR = 3.7; 95% CI 1.5-9.0; p = 0.004). Invasion ≥ 3 mm increased the probability of early recurrence by 3.8 times (OR = 3.8; 95% CI 1.8-7.9; p < 0.001). Simpson III-V resection was associated with a 2.6-fold increase in relapse odds compared to I-II (OR = 2.6; 95% CI 1.3-5.4; p = 0.007). Five-year relapse rates in the groups of low and high marker values: Grade I - 9.8%; Grade II - 28.1%; Grade III - 60%. Conclusion: Elevated Ki-67 and CD34, deep invasion (≥ 3 mm) and less radical resection (Simpson III-V) are independent predictors of meningioma recurrence. The inclusion of these four parameters in postoperative risk stratification allows reasonable planning of adjuvant therapy and rehabilitation, as well as individualisation of the patient observation regime

Keywords: meningiomas, tumour activity, angiogenesis, invasion, quantitative assessment, prognosis, relapse, rehabilitation

First page

23

Last page

31

For citation:Ravshanov D.M., Mavlyanova Z.F., Ashurov R.F. - HISTOPATHOLOGICAL MARKERS OF RECURRENCE RISK OF INTRACRANIAL MENINGIOMAS AND THEIR IMPACT ON THE REHABILITATION POTENTIAL//New Day in Medicine 8(82)2025 23-31 https://newdayworldmedicine.com/en/new_day_medicine/8-82-2025

List of References

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