Meningioma and Bone Hyperostosis

Expression of Bone Stimulating Factors and Review of the Literature

Andrea Di Cristofori, Massimiliano Del Bene, Marco Locatelli, Francesca Boggio, Giulia Ercoli, Stefano Ferrero, Alessandro Del Gobbo

Research output: Contribution to journalReview article

Abstract

BACKGROUND: Several hypotheses have been proposed regarding the mechanisms underlying meningioma-related hyperostosis. In this study, we investigated the role of osteoprotegerin (OPG), insulin-like growth factor 1 (IGF-1), endothelin 1 (ET-1), and bone morphogenetic protein (BMP) 2 and 4.

METHODS: A total of 149 patients (39 males and 110 females; mean age, 62 years) who underwent surgery were included. Depending on the relationship with the bone, meningiomas were classified as hyperostotic, osteolytic, infiltrative, or unrelated. Expression of OPG, and IGF-1, ET-1, BMP-2, and BMP-4 was evaluated by tissue microarray analysis of surgical samples.

RESULTS: Our series comprised 132 cases of grade I, 14 cases of grade II, and 3 cases of grade III meningiomas, according to the World Health Organization classification. Based on preoperative computed tomography scan, the cases were classified as follows: hyperostotic, n = 11; osteolytic, n = 11; infiltrative, n = 15; unrelated to the bone, n = 108. Four cases were excluded from the statistical analysis. Using receiver operating characteristic curve analysis, we identified a 2% cutoff for the mean value of IGF-1 that discriminated between osteolytic and osteoblastic lesions; cases with a mean IGF-1 expression of <2% were classified as osteolytic (P = 0.0046), whereas those with a mean OPG expression of <10% were classified as osteolytic (P = 0.048). No other significant relationships were found.

CONCLUSIONS: Expression of OPG and expression of IGF-1 were found to be associated with the development of hyperostosis. Preliminary findings suggest that hyperostosis can be caused by an overexpression of osteogenic molecules that influence osteoblast/osteoclast activity. Based on our results, further studies on hyperostotic bony tissue in meningiomas are needed to better understand how meningiomas influence bone overproduction.

Original languageEnglish
Pages (from-to)e774-e781
JournalWorld Neurosurgery
Volume115
DOIs
Publication statusPublished - Jul 2018

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Hyperostosis
Meningioma
Somatomedins
Osteoprotegerin
Bone and Bones
Bone Morphogenetic Protein 4
Bone Morphogenetic Protein 2
Endothelin-1
Tissue Array Analysis
Osteoclasts
Osteoblasts
ROC Curve
Tomography

Keywords

  • Biomarkers/metabolism
  • Bone Morphogenetic Protein 2/biosynthesis
  • Bone Morphogenetic Proteins/biosynthesis
  • Endothelin-1/biosynthesis
  • Female
  • Gene Expression
  • Humans
  • Hyperostosis/diagnostic imaging
  • Insulin-Like Growth Factor I/biosynthesis
  • Male
  • Meningeal Neoplasms/diagnostic imaging
  • Meningioma/diagnostic imaging
  • Middle Aged
  • Osteoprotegerin/biosynthesis

Cite this

Meningioma and Bone Hyperostosis : Expression of Bone Stimulating Factors and Review of the Literature. / Di Cristofori, Andrea; Del Bene, Massimiliano; Locatelli, Marco; Boggio, Francesca; Ercoli, Giulia; Ferrero, Stefano; Del Gobbo, Alessandro.

In: World Neurosurgery, Vol. 115, 07.2018, p. e774-e781.

Research output: Contribution to journalReview article

@article{808e18caa08649e08d13d82cbf739b4b,
title = "Meningioma and Bone Hyperostosis: Expression of Bone Stimulating Factors and Review of the Literature",
abstract = "BACKGROUND: Several hypotheses have been proposed regarding the mechanisms underlying meningioma-related hyperostosis. In this study, we investigated the role of osteoprotegerin (OPG), insulin-like growth factor 1 (IGF-1), endothelin 1 (ET-1), and bone morphogenetic protein (BMP) 2 and 4.METHODS: A total of 149 patients (39 males and 110 females; mean age, 62 years) who underwent surgery were included. Depending on the relationship with the bone, meningiomas were classified as hyperostotic, osteolytic, infiltrative, or unrelated. Expression of OPG, and IGF-1, ET-1, BMP-2, and BMP-4 was evaluated by tissue microarray analysis of surgical samples.RESULTS: Our series comprised 132 cases of grade I, 14 cases of grade II, and 3 cases of grade III meningiomas, according to the World Health Organization classification. Based on preoperative computed tomography scan, the cases were classified as follows: hyperostotic, n = 11; osteolytic, n = 11; infiltrative, n = 15; unrelated to the bone, n = 108. Four cases were excluded from the statistical analysis. Using receiver operating characteristic curve analysis, we identified a 2{\%} cutoff for the mean value of IGF-1 that discriminated between osteolytic and osteoblastic lesions; cases with a mean IGF-1 expression of <2{\%} were classified as osteolytic (P = 0.0046), whereas those with a mean OPG expression of <10{\%} were classified as osteolytic (P = 0.048). No other significant relationships were found.CONCLUSIONS: Expression of OPG and expression of IGF-1 were found to be associated with the development of hyperostosis. Preliminary findings suggest that hyperostosis can be caused by an overexpression of osteogenic molecules that influence osteoblast/osteoclast activity. Based on our results, further studies on hyperostotic bony tissue in meningiomas are needed to better understand how meningiomas influence bone overproduction.",
keywords = "Biomarkers/metabolism, Bone Morphogenetic Protein 2/biosynthesis, Bone Morphogenetic Proteins/biosynthesis, Endothelin-1/biosynthesis, Female, Gene Expression, Humans, Hyperostosis/diagnostic imaging, Insulin-Like Growth Factor I/biosynthesis, Male, Meningeal Neoplasms/diagnostic imaging, Meningioma/diagnostic imaging, Middle Aged, Osteoprotegerin/biosynthesis",
author = "{Di Cristofori}, Andrea and {Del Bene}, Massimiliano and Marco Locatelli and Francesca Boggio and Giulia Ercoli and Stefano Ferrero and {Del Gobbo}, Alessandro",
note = "Copyright {\circledC} 2018 Elsevier Inc. All rights reserved.",
year = "2018",
month = "7",
doi = "10.1016/j.wneu.2018.04.176",
language = "English",
volume = "115",
pages = "e774--e781",
journal = "World Neurosurgery",
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TY - JOUR

T1 - Meningioma and Bone Hyperostosis

T2 - Expression of Bone Stimulating Factors and Review of the Literature

AU - Di Cristofori, Andrea

AU - Del Bene, Massimiliano

AU - Locatelli, Marco

AU - Boggio, Francesca

AU - Ercoli, Giulia

AU - Ferrero, Stefano

AU - Del Gobbo, Alessandro

N1 - Copyright © 2018 Elsevier Inc. All rights reserved.

PY - 2018/7

Y1 - 2018/7

N2 - BACKGROUND: Several hypotheses have been proposed regarding the mechanisms underlying meningioma-related hyperostosis. In this study, we investigated the role of osteoprotegerin (OPG), insulin-like growth factor 1 (IGF-1), endothelin 1 (ET-1), and bone morphogenetic protein (BMP) 2 and 4.METHODS: A total of 149 patients (39 males and 110 females; mean age, 62 years) who underwent surgery were included. Depending on the relationship with the bone, meningiomas were classified as hyperostotic, osteolytic, infiltrative, or unrelated. Expression of OPG, and IGF-1, ET-1, BMP-2, and BMP-4 was evaluated by tissue microarray analysis of surgical samples.RESULTS: Our series comprised 132 cases of grade I, 14 cases of grade II, and 3 cases of grade III meningiomas, according to the World Health Organization classification. Based on preoperative computed tomography scan, the cases were classified as follows: hyperostotic, n = 11; osteolytic, n = 11; infiltrative, n = 15; unrelated to the bone, n = 108. Four cases were excluded from the statistical analysis. Using receiver operating characteristic curve analysis, we identified a 2% cutoff for the mean value of IGF-1 that discriminated between osteolytic and osteoblastic lesions; cases with a mean IGF-1 expression of <2% were classified as osteolytic (P = 0.0046), whereas those with a mean OPG expression of <10% were classified as osteolytic (P = 0.048). No other significant relationships were found.CONCLUSIONS: Expression of OPG and expression of IGF-1 were found to be associated with the development of hyperostosis. Preliminary findings suggest that hyperostosis can be caused by an overexpression of osteogenic molecules that influence osteoblast/osteoclast activity. Based on our results, further studies on hyperostotic bony tissue in meningiomas are needed to better understand how meningiomas influence bone overproduction.

AB - BACKGROUND: Several hypotheses have been proposed regarding the mechanisms underlying meningioma-related hyperostosis. In this study, we investigated the role of osteoprotegerin (OPG), insulin-like growth factor 1 (IGF-1), endothelin 1 (ET-1), and bone morphogenetic protein (BMP) 2 and 4.METHODS: A total of 149 patients (39 males and 110 females; mean age, 62 years) who underwent surgery were included. Depending on the relationship with the bone, meningiomas were classified as hyperostotic, osteolytic, infiltrative, or unrelated. Expression of OPG, and IGF-1, ET-1, BMP-2, and BMP-4 was evaluated by tissue microarray analysis of surgical samples.RESULTS: Our series comprised 132 cases of grade I, 14 cases of grade II, and 3 cases of grade III meningiomas, according to the World Health Organization classification. Based on preoperative computed tomography scan, the cases were classified as follows: hyperostotic, n = 11; osteolytic, n = 11; infiltrative, n = 15; unrelated to the bone, n = 108. Four cases were excluded from the statistical analysis. Using receiver operating characteristic curve analysis, we identified a 2% cutoff for the mean value of IGF-1 that discriminated between osteolytic and osteoblastic lesions; cases with a mean IGF-1 expression of <2% were classified as osteolytic (P = 0.0046), whereas those with a mean OPG expression of <10% were classified as osteolytic (P = 0.048). No other significant relationships were found.CONCLUSIONS: Expression of OPG and expression of IGF-1 were found to be associated with the development of hyperostosis. Preliminary findings suggest that hyperostosis can be caused by an overexpression of osteogenic molecules that influence osteoblast/osteoclast activity. Based on our results, further studies on hyperostotic bony tissue in meningiomas are needed to better understand how meningiomas influence bone overproduction.

KW - Biomarkers/metabolism

KW - Bone Morphogenetic Protein 2/biosynthesis

KW - Bone Morphogenetic Proteins/biosynthesis

KW - Endothelin-1/biosynthesis

KW - Female

KW - Gene Expression

KW - Humans

KW - Hyperostosis/diagnostic imaging

KW - Insulin-Like Growth Factor I/biosynthesis

KW - Male

KW - Meningeal Neoplasms/diagnostic imaging

KW - Meningioma/diagnostic imaging

KW - Middle Aged

KW - Osteoprotegerin/biosynthesis

U2 - 10.1016/j.wneu.2018.04.176

DO - 10.1016/j.wneu.2018.04.176

M3 - Review article

VL - 115

SP - e774-e781

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -