MUC4 and Caspase-3 Immunoexpression in Meningioma: A Histopathological Study Linking Mucin & Apoptotic Pathways

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BACKGROUND: The most frequent intracranial primary tumors of the central nervous system and the second most frequent tumors of the brain are meningiomas. Although most of them are benign, a subset of them is biologically aggressive, exhibiting aggressive growth behavior and brain invasion. MATERIALS AND METHODS: Fifty-nine cases of various grades & subtypes of meningiomas were included in this retrospective study. Samples were immunohistochemically analyzed for MUC4 & Caspase-3 antibodies and correlated with clinico-pathologic variables. RESULTS: MUC4 was expressed in 36 (61%) cases of meningioma. Statistically, MUC4 expression, the percentage of positivity of tumor cells, and the intensity were significantly positively correlated with the WHO grade of meningioma cases (p-value = 0.03, 0.006, and 0.002, respectively) and the meningioma histologic subtype (p-value = 0.002, 0.002, and 0.000, respectively). Caspase-3 was expressed in 48 (81.4%) cases of meningioma. Caspase-3 expression was statistically significantly inversely correlated with the WHO grade of the analyzed tumors (p-value= 0.005) and the meningioma histologic subtype (p-value= 0.014). There is an inverse statistically significant correlation between the intensity of MUC4 & Caspase-3 expression (p-value= 0.002). CONCLUSION: Our results suggest that MUC4 is associated with higher grades of meningiomas and may have a negative impact on prognosis and recurrence rates, potentially making it a target for an agent with mucolytic effects that can help overcome chemoresistance in aggressive meningiomas. On the other hand, the expression of Caspase-3 correlates with the grade of differentiation and certain histotypes and may be considered as an ideal target for meningioma therapeutic regimens.

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