Abstract
Ki-67 Labeling Index is an immunocytochemical marker of cell proliferation. The correlation of Ki-67 expression with pituitary adenomas recurrence has been investigated and is highly debated. Aim of this study was to evaluate whether Ki-67 correlates with recurrence even in patients with an apparently completely removed pituitary adenoma. We retrospectively reviewed the database of the Hypothalamic-Pituitary Disease Unit at the Catholic University of Rome, collected between 2003 and 2011. Inclusion criteria were: patients who underwent surgery at the Department of Neurosurgery with an apparently complete removal of a pituitary adenoma; Ki-67 histological evaluation by the same operator and values of <3 %. All patients underwent endocrine evaluation of the hypothalamic-pituitary function, ophthalmologic and neuro-radiological examinations, during the preoperative period and follow-up. Out of 490 patients recorded on the database of the Hypothalamic-Pituitary Disease Unit at the Catholic University of Rome, 191 cases met the inclusion criteria. Recurrence was observed in 49 cases (25.7 % of the patients who had undergone radical excision). Optional cut-off value was identified at Ki-67 values of 1.50 %. This was associated with worse disease-free survival time, even after correction for age at treatment, gender, positivity to p53, functional classification and Knosp grading. Ki-67 labeling index may be useful in postoperative management, even in patients who underwent radical PA removal. We suggest a Ki-67 cut-off value of 1.5 % to plan an adequate clinical follow-up.
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Abbreviations
- ACTH:
-
Adrenocorticotrophic hormone
- ACTH-oma:
-
ACTH secreting pituitary adenoma
- CI:
-
Confidence interval
- CS:
-
Cavernous sinus
- CSPA:
-
Cavernous sinus invasive pituitary adenoma
- FSH:
-
Follicle stimulating hormone
- GH:
-
Growth hormone
- GH-oma:
-
GH-secreting pituitary adenoma
- GSA:
-
Gonadotropic adenomas
- Ki-67 LI:
-
Ki-67 labeling index
- ICA:
-
Internal carotid artery
- LH:
-
Lutein hormone
- NFPA:
-
Non-functioning pituitary adenomas
- PA:
-
Pituitary adenoma
- PRL:
-
Prolactin
- PRL-oma:
-
PRL secreting pituitary adenoma
- RR:
-
Recurrence rate
- TSH:
-
Thyroid stimulating hormone
- TSH-oma:
-
TSH secreting pituitary adenoma
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This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
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The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
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Chiloiro, S., Bianchi, A., Doglietto, F. et al. Radically resected pituitary adenomas: prognostic role of Ki 67 labeling index in a monocentric retrospective series and literature review. Pituitary 17, 267–276 (2014). https://doi.org/10.1007/s11102-013-0500-6
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DOI: https://doi.org/10.1007/s11102-013-0500-6