Immunohistochemistry expression of stem cell markers SOX2, OCT4, CD133 in different grades of meningiomas and correlation with Ki 67 index.

Background: There is accumulating evidence of the presence of Cancer Stem Cells (CSCs) within meningiomas (MGs). In the present study, we assessed the Immunohistochemistry (IHC) expression of stem cell markers SOX2, OCT4, CD133 in different grades of MGs and their correlation with Ki 67 index.

Methods: A cross-sectional analytical study where 140 MGs cases were graded and classified according to WHO-2021 classification. IHC for SOX2, OCT4, CD133 and Ki-67 was carried out.

Results: Out of 140 cases, 59 cases (42.1%) showed OCT4 positivity, 38 cases (27.1%) showed CD133 positivity and only 21 cases (15%) showed SOX2 positivity. Ki 67 index ranged from 1-30%. Statistically significant difference (Chi Square p-value <0.001) was found between SOX 2, OCT4 and CD133 expressions (positive/negative) and the grades of MG cases. As the grades of MG cases increased, the positive expression of SOX2, OCT 4 and CD 133 also increased. The Mean Ki 67 index value was significantly raised when SOX2, OCT 4 and CD 133 IHC expressions were positive (Student t Test p-value <0.001).

Conclusion: Our results strongly support the hypothesis of presence of CSCs, in MGs regardless of their grade. We recommend that CSCs IHC markers (SOX2, OCT4 and CD133) to be used on initial diagnosis in all cases of MGs along with Ki-67 index. It can help quantitate CSCs and in turn, recommend closer follow up in patients with high percentage of CSCs to predict early recurrence.