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Radically resected pituitary adenomas: prognostic role of Ki 67 labeling index in a monocentric retrospective series and literature review

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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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Acknowledgments

This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Conflict of interest

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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Authors and Affiliations

  1. Section of Endocrinology, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Policlinico Gemelli, Largo A. Gemelli, 8, 00168, Rome, Italy

    Sabrina Chiloiro, Antonio Bianchi, Antonella Giampietro, Alessandra Fusco, Donato Iacovazzo, Linda Tartaglione, Alfredo Pontecorvi & Laura De Marinis

  2. Institute of Neurosurgery, Università Cattolica del Sacro Cuore, Policlinico Gemelli, Largo A. Gemelli, 8, 00168, Rome, Italy

    Francesco Doglietto, Francesco Signorelli, Carmelo Anile & Giulio Maira

  3. Institute of Hygiene, Università Cattolica del Sacro Cuore, Policlinico Gemelli, Largo A. Gemelli, 8, 00168, Rome, Italy

    Chiara de Waure & Francesco Di Nardo

  4. Institute of Anatomic Pathology, Università Cattolica del Sacro Cuore, Policlinico Gemelli, Largo A. Gemelli, 8, 00168, Rome, Italy

    Libero Lauriola & Guido Rindi

Authors
  1. Sabrina Chiloiro
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  2. Antonio Bianchi
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  16. Laura De Marinis
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Correspondence to Sabrina Chiloiro.

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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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