Increased expression of leucine-rich α-2 glycoprotein 1 as a predictive biomarker of favorable progression-free survival in meningioma

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Abstract Purpose Most meningiomas, which are frequent central nervous system tumors, are classified as WHO grade 1 because of their slow growing nature. However, the recurrence rate varies and is difficult to predict using conventional histopathological diagnoses. Leucine-rich α-2 glycoprotein 1 (LRG1) is involved in cell signal transduction, cell adhesion, and DNA repair and is a predictive biomarker in different malignant tumors; however, such a relationship has not been reported in meningiomas. Methods/patients We examined tissue microarrays of histological samples from 121 patients with grade I and grade II meningiomas and assessed their clinical and pathological features, including expression of LRG1 protein. Results LRG1-high meningiomas showed increased number of vessels with CD3 positive cell infiltration (p=0.0453) as well as higher CD105 positive vessels (p=0.0041), as compared to LRG1-low cases. They also demonstrated better progression-free survival [hazard ratio (HR) 0.24, 95 % confidence interval (CI) 0.056-0.99] compared to LRG1-low patients (p=0.0317). Moreover, multivariate analysis indicated that high LRG1 expression was an independent prognostic factor (HR, 0.22; CI, 0.05-0.95; p=0.0426). Conclusions LRG1 immunohistochemistry may be a convenient tool for estimating the prognosis of meningiomas in routine practice. Further studies are required to elucidate the key role of LRG1 in meningioma progression.

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