Expression of Pancytokeratin in Meningioma in Correlation with Ki67 Proliferative Index

Abstract

Background: Meningioma is the most common primary central nervous system tumor. However, its cellular origin remains unclear. While keratin expression is noted in some variants, PanCK expression in grade I and II meningiomas is poorly characterized.

Objective: To assess PanCK expression across meningioma grades and variants and correlate it with mitotic count and Ki67 index.

Methods: A cross-sectional study was conducted at Gazi Al-Hariri Hospital (2022–2023) including 28 grade I–III meningiomas. Clinical data were collected, and immunohistochemistry for PanCK and Ki67 was performed.

Results: The mean patient age was 49.7 years (range 30–75), with a female predominance (1:8.3). Grade II tumors were most common (60%). All anaplastic meningiomas expressed PanCK strongly. Meningothelial variants were PanCK-negative in 57.1% of cases, whereas transitional and chordoid types showed moderate expression. Atypical variants showed variable expression. Expression differed significantly by variant (P=0.007) and grade. All grade III tumors showed strong PanCK expression; 50% of grade I and 52.9% of grade II lacked expression. PanCK score correlated moderately with Ki67 (r=0.504), mitotic count (r=0.433), and grade (r=0.411).

Conclusion: PanCK expression spans all meningioma grades, limiting the diagnosing specificity; its linear correlation with Ki67 suggests involvement in tumor proliferation.