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Background: Meningiomas are the most common primary central nervous system tumours in adults. Meningiomas are slow growing tumours with a female predominance. Radiological techniques have limited ability to differentiate the subtypes of meningiomas. Grading system based on histopathological features has certain limitations in predicting the exact biological behaviour of meningiomas. Hence the use of ancillary technique is necessitatedto predict the tumour growth and recurrence. Ki67 is the most widely used immunohistochemical marker. Aim of study is to know Ki 67 proliferative index in three grades of meningiomas. Materials and methods: It is a hospital based observational study for a period of 2 years. Sample size includes 50 cases.Tissues were routinely processed and stained with hematoxylin and eosin and classified according to WHO 2016 classification. Ki 67 stains were done using poly Excel HRP/DAB Detection system. .Ki 67 labelling index: 1000 nuclei examined under 400X and results were expressed as percentage of positively stained nuclei.Interpretation of Ki 67 for Meningiomas was done based on Mukherjee et al. study. Results: Out of 50 cases most common subtype encountered is meningothelial meningioma (50%) which is grade I tumours. Grade II and Grade III tumours accounting for 6% and 2. % .Mean ki67 proliferative index for grade I,grade II and grade III are 2.29%, 7% and 21% respectively. Conclusion: The major prognostic factors for recurrence include tumour grade, biological behaviour of tumour and extent of surgery. Ki 67 helps in predicting tumour behaviour. Therefore Ki 67 index can be used as an accessory tool to grading system and helps the surgeon in establishing better follow up criteria and long term management strategies for the benefit of the patient.

Clinico-Histopathological Study of Meningiomas in Correlation with Proliferative Index Ki-67