- Background: Cystic vestibular schwannomas are notorious for unpredictable biological and clinical behavior, faster growth rates and poorer treatment outcomes, presumably as a result of the inflammatory reaction and adhesions between the tumor and surrounding neural structures. This highly variable condition makes tumor growth prediction and management challenging. Different immune cell infiltration patterns between solid and cystic tumors might help to unveil new insights into the pro-tumorogenic role of inflammation in vestibular schwannoma.
Methods: We conducted a retrospective analysis of primary sporadic vestibular schwannomas, that were surgically treated at a single center from 2003 to 2017 (n=758). Comparison between solid (n=668) and cystic (n=90) tumors was performed regarding patient demographics, preoperative radiological images, volumetric analysis, tumor growth rate, immunohistochemical evaluation for tumor cell proliferation (MIB1), lymphocyte (CD3 and CD8,) andBackground: Cystic vestibular schwannomas are notorious for unpredictable biological and clinical behavior, faster growth rates and poorer treatment outcomes, presumably as a result of the inflammatory reaction and adhesions between the tumor and surrounding neural structures. This highly variable condition makes tumor growth prediction and management challenging. Different immune cell infiltration patterns between solid and cystic tumors might help to unveil new insights into the pro-tumorogenic role of inflammation in vestibular schwannoma.
Methods: We conducted a retrospective analysis of primary sporadic vestibular schwannomas, that were surgically treated at a single center from 2003 to 2017 (n=758). Comparison between solid (n=668) and cystic (n=90) tumors was performed regarding patient demographics, preoperative radiological images, volumetric analysis, tumor growth rate, immunohistochemical evaluation for tumor cell proliferation (MIB1), lymphocyte (CD3 and CD8,) and macrophage infiltration (CD68 and CD163) and expression of the enzyme cyclooxygenase 2 (COX2).
Results: Overall, 11,9% of tumors were cystic, which showed larger preoperative tumor volumes (p<0,001). Volumetric tumour growth expressed as difference in volume in cm3 per year, was significantly different between cystic and solid tumors, with cystic tumors presenting a faster growth (p<0,001). However, when looking at the percentual volumetric tumor growth, no significant difference was found. Regarding differences between the immunohistochemical markers expression in cystic and solid tumors, a higher proliferative activity (MIB1 expression) was seen in solid tumors (p=0,003), while a higher expression score of CD3 (p<0,001), CD8 (p<0,001) and CD163 (p=0,009) was associated with cystic tumors. In contrast, the expression of CD68 and COX2 did not show significant differences.
Conclusions: Among vestibular schwannomas, cystic tumors show higher expression scores of lymphocyte (CD3 and CD8,) and macrophage (CD163) markers.…
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