The role of vascular endothelial growth factor in predicting the tumor dynamics of meningiomas

Background: Meningiomas are the most common tumors of the central nervous system with variable tumor dynamics. Histopathology is the gold standard but has its own constraints in predicting the tumor behavior. As intra- tumoral hypoxia leads to neo angio angiogenesis and subsequent tumor growth we envisage to establish the role of vascular endothelial growth factor (VEGF) in predicting the tumor dynamics of meningiomas.Methods: This observational, descriptive, longitudinal follow up study included 38 patients and spanned over a period of 2 years. Surgical samples were grossed and histo-pathologically analyzed and subsequently immune-histochemically categorized. Cases showing VEGF positivity were subjected to yearly follow up to ascertain the number of recurrent cases.Results: Majority of our cases belonged to WHO grade I (84.21%). The 73.68% were females. The 63.16% were aged >50 years. The 42.1 % of the total cases revealed moderate to strong VEGF expression. Majority of grade II and grade III meningiomas showed moderate to strong VEGF expression. However, a subgroup of grade I meningiomas also revealed a high immune-expression of VEGF (31.25%). Statistically significant association was found between VEGF expression and WHO grade (p=0.0001). On follow up 34.21% of the cases showed recurrence. Significant association was found between VEGF expression and recurrence of the tumor s (p=0.0005).Conclusions: VEGF has a role in ascertaining the high-risk grade I meningiomas that have a potential to recur as well as grade II and grade III meningiomas that show adverse patient prognosis.