Conventional morphologic criteria as studied in routine Haematoxylin and Eosin stained sections (H & E) may not be accurate in grading and assessing prognosis in small stereotactic biopsy specimens. Thus, arises the need for objective methods for assessing tumour biology. Angiogenesis is a key event in the spread of tumours and denotes a poor prognosis. Intratumoural Microvessel Density (MVD) helps in quantification of angiogenesis.

[[MIB-1 index]] LI is an important complementary tool to accurately grade meningothelial tumours and assess tumour biology. Specific cycling endothelial markers along with CD 34 & MVD could be used to assess the prognosis of these tumours
((Bohra H, Rathi KR, Dudani S, Bohra A, Vishwakarma S, Sahai K. The Study of
MIB-1 LI and CD 34 As A Marker of Proliferative Activity and Angiogenesis in
Different Grades of Meningioma. J Clin Diagn Res. 2016 Aug;10(8):EC14-7. doi:
10.7860/JCDR/2016/12690.8328. Epub 2016 Aug 1. PubMed PMID: 27656445; PubMed
Central PMCID: PMC5028582.
)).


Due to variation between institutions and observers, it is advised that proliferation indices (e.g. [[Ki-67]] or [[MIB-1]] not be used as the sole discriminant for grading. However, these indices do correlate with prognosis. Adding the phrase “with high proliferative activity” is suggested for tumors with a very high index
((Kleihues P, Louis DN, Scheithauer BW, et al. The WHO classification of tumors of the nervous sys- tem. J Neuropathol Exp Neurol. 2002; 61:215–25; discussion 226-9)).