Analysis of clinical features, prognosis and potential target genes of refractory meningioma-- Research based on multiple databases

Objective: Analyzing SEER database data on malignant meningiomas, we explored high-risk factors for refractory meningiomas (RMs). Additionally, we analyzed GEO database genes across WHO grades to identify key genes and malignant risk factors for RMs. Immunohistochemical analysis was performed on WHO grade meningiomas' pathological specimens to verify hub gene expression differences. Methods: We included clinical cases of malignant meningiomas diagnosed in the SEER database. GEO database provided a gene expression profile dataset of 252 samples. Significant expression differences yielded screened genes, constructing a PPI network and identifying common hub genes. Hub gene-WHO classification correlation was assessed. A single center collected 38 meningioma samples grouped by WHO grade. Immunohistochemistry confirmed hub gene expressions. Results: SEER study: Multivariate COX analysis revealed age (P < 0.001), sex (P=0.071), chemotherapy (P < 0.001), and tumor size (P=0.003) as statistically significant prognostic factors. Gene database analysis: Differential genes ErbB3 and EGFR were identified; Progesterone and estrogen receptors PR and ER were also included, with distinct expressions across WHO grades (P < 0.001), except for ER. Pathological data study: EGFR correlated positively with WHO grade (r=0.396, P=0.014). ErbB3 (r=-0.487, p=0.002), ER (r=-0.396, P= 0.002), and egfr (r=-0.396, P=0.014) correlated negatively. nPR (r=-0.519, P < 0.001) and PR (r=-0.218, p=0.189) correlated negatively. nEGFR (r=-0.061, p=0.717) were not significant. ER (r=-0.316, P=0.065) and nPR (r=-0.443, P=0.008) correlated negatively with recurrence. Conclusion: EGFR, ErbB3, ER, and nPR might be potential RM diagnostic and treatment targets. mPR distribution discrepancies may hold diagnostic and therapeutic importance under new classifications or definitions.