Meningiomas are the most common primary central nervous system tumors and exhibit heterogeneous biological behavior across WHO grades. Emerging evidence suggests that purinergic signaling and immune-related pathways may contribute to meningioma biology.

This study evaluated the expression and activity of CD39/ENTPD1 and CD73/NT5E, the expression of PD-L1/CD274, and the systemic inflammatory profile in patients undergoing surgical resection of meningiomas.

Forty patients were included, with specific subgroups available for molecular, immunohistochemical, enzymatic, and cytokine analyses. Molecular comparisons were restricted to WHO grade 1 and grade 2 tumors. NT5E/CD73 expression was higher in WHO grade 2 tumors at both mRNA and protein levels, whereas CD274/PD-L1 expression was lower. Peripheral CD39/CD73 enzymatic activity also differed between study groups, while plasma cytokines showed non-significant trends toward higher concentrations in patients with WHO grade 2 tumors.