RELATIONSHIP BETWEEN EXPRESSION CLUSTER OF DIFFERENTIATION 44 (CD44) WITH MITOSIS, GRADE AND BRAIN INVASION IN MENINGIOMA

Abstract

Meningioma is the most common brain tumor. Most cases are benign with slow growth. WHO grade 2 and 3 meningiomas have a more aggressive behavior and with high recurrence. CD44 is a cell surface glycoprotein that has an important role in proliferation, cellular adhesion, migration, and angiogenesis. This study is a cross sectional study with a sample of 40 cases of meningioma at Prof. Dr. I.G.N.G. Ngoerah Hospital in 2019-2022 consisting of 20 grade 1 cases, 14 grade 2 cases, and 6 grade 3 cases. Clinical and radiological data were obtained from SIMRS. Hematoxylin-Eosin slide re-evaluation was performed to assess mitosis and tumor invasion into the brain. CD44 expression was evaluated by immunohistochemistry. Descriptive analysis to determine the frequency of the characteristics of the study subjects and chi square analysis to analyze the relationship between CD44 expression with mitosis, grade, and brain invasion. Significance was determined at p < 0.05. The results obtained were 25 cases (62.5%) aged in the fourth decade, 30 (75%) cases were female, 24 (60%) cases were located in non-convexity, 26 (65%) cases with size <6 cm, 20 (50%) cases grade 1, 7 (17.5%) cases showed brain invasion and 26 (65%) cases had mitosis <4/10 LPB. CD44 expression was weak in 11 (27.5%) cases, moderate expression in 17 (42.5%) cases and strong expression in 12 (30%) cases. In bivariate analysis, there was a significant association between CD44 and mitosis (p = 0.011), grade (p = 0.004), and brain invasion (p = 0.023). In conclusion, there is a significant association between CD44 expression with mitosis, grade, and brain invasion in meningioma.