KI-67 labeling index and expression of P53 are non-predictive on invasiveness and tumour size in functional and nonfunctional pituitary adenomas: A large series of 421 patients

Object In residual nonfunctioning pituitary adenomas, reliable prognostic parameters indicating probability of tumor progression are needed. The Ki 67 expression/MIB-1 labeling index (LI) is considered to be a promising candidate factor. The aim in the present study was to analyze the clinical usefulness of MIB-1 LI for prognosis of tumor progression. Methods The authors studied a cohort of 92 patients with nonfunctioning pituitary adenomas. Based on sequential postoperative MR images, patients were classified as tumor free (51 patients) or as harboring residual tumor (41 individuals). The residual tumor group was further subdivided in groups with stable residual tumors (14 patients) or progressive residual tumors (27 patients). The MIB-1 LI was assessed in tumor specimens obtained in all patients, and statistical comparisons of MIB-1 LI of the various subgroups were performed. Results . The authors found no significant difference of MIB-1 LI in the residual tumor group compared with the tumor-free group. However, MIB-1 LI was significantly higher in the progressive residual tumor group, compared with the stable residual tumor group. Additionally, the time period to second surgery was significantly shorter in residual adenomas showing an MIB-1 LI > 3%. Conclusions The data indicate that MIB-1 LI in nonfunctioning pituitary adenomas is a clinically useful prognostic parameter indicating probability of progression of postoperative tumor remnants. The MIB-1 LI may be helpful in decisions of postoperative disease management (for example, frequency of radiographic intervals, planning for reoperation, radiotherapy, and/or radiosurgery).

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Factors That Predict the Growth of Residual Nonfunctional Pituitary Adenomas: Correlations between Relapse and Cell Cycle Markers

BioMed Research International ◽

10.1155/2018/1876290 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Petr Matoušek ◽

Petr Buzrla ◽

Štefan Reguli ◽

Jan Krajča ◽

Jana Dvořáčková ◽

...

Keyword(s):

Protein Expression ◽

Pituitary Adenomas ◽

Clinical Symptoms ◽

Statistical Significance ◽

Residual Tumor ◽

Partial Resection ◽

Ki 67 ◽

Increased Risk ◽

Nonfunctional Pituitary Adenomas ◽

Remnant Tumor

Introduction. Nonfunctional pituitary adenomas are treated surgically, and even partial resection can improve or eliminate clinical symptoms. Notably, progression requires further intervention, which presents an increased risk, especially in older patients. This study investigated whether the histopathological characteristics of nonfunctional adenomas could predict recurrence. Materials and Methods. Data were obtained retrospectively from 30 patients who underwent surgery for the partial resection of pituitary adenomas. Remnant tumor growth was observed in 17 patients, while the residual tumor was unchanged more than 7 years after surgery in 13 patients. Statistical analysis was performed to investigate correlations between remnant tumor progression and tumor histopathological findings, including protein expression of p21, p27, p53, and Ki-67. Results and Discussion. Remnant tumors that demonstrated regrowth showed significantly higher protein expression of p21 and Ki-67. Expression of the p53 tumor suppressor was also higher in this group, but the difference was at the limit of statistical significance. Conclusion. Tumors with high expression of p21 and p53 and with a high Ki-67 index were more likely to show residual pituitary adenoma progression. Such cases should undergo frequent radiological examination and timely reoperation, and radiosurgery should be considered.

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The Past, Present, and Future Statuses of Formerly Classified “Atypical Pituitary Adenomas”: A Clinicopathological Assessment of 101 Cases in a Cohort of More than 1,000 Pure Endoscopically Treated Patients in Single Center

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0040-1702219 ◽

2020 ◽

Author(s):

Ercan Bal ◽

İbrahim Kulaç ◽

Selim Ayhan ◽

Figen Söylemezoğlu ◽

Mustafa Berker

Keyword(s):

Pituitary Adenomas ◽

Labeling Index ◽

World Health ◽

Pituitary Neoplasms ◽

Ki 67 ◽

Cavernous Sinus Invasion ◽

Atypical Adenoma ◽

Endocrine Organs ◽

Significant Difference ◽

Cure Rates

Abstract Aim This study was aimed to assess the clinical aggressiveness of pituitary neoplasms that were previously defined as atypical adenomas. Methods A total of 1,042 pituitary adenomas were included in the study and 101 of them were diagnosed as atypical adenoma. Demographic characteristics, radiological evaluations, and clinical information were obtained from a computer-based patient database. Cases were categorized as atypical or typical using the criteria listed in 2004 Classification of Tumors of Endocrine Organs. Results The cure and reoperation rates did not show any statistically significant difference between the typical and atypical adenomas. However, a higher Ki-67 labeling index was found to be associated with a higher rate of reoperation (p = 0.008) in atypical adenomas. Of note, cavernous sinus invasion or parasellar extension was found to be associated with lower cure rates in patients with atypical pituitary adenomas (p < 0.001 and p = 0.001, respectively). Conclusion Although atypical pituitary adenomas are known to be more invasive, this study demonstrated that the reoperation and cure rates are the same for typical and atypical adenomas. Our findings advocate for omitting the use of atypical adenoma terminology based solely on pathological evaluation. As stated in the 4th edition of the World Health Organization (WHO) classification, accurate tumor subtyping, evaluation of proliferation by means of mitotic count and Ki-67 labeling index, and radiological and intraoperative assessments of tumor invasion should be taken into consideration in the management of such neoplasms.

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