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

Sabrina Chiloiro, Guido Rindi, Alfredo Pontecorvi, Antonio Bianchi, Francesco Doglietto, Chiara De Waure, Antonella Giampietro, Alessandra Fusco, Donato Iacovazzo, Linda Tartaglione, Francesco Di Nardo, Francesco Signorelli, Libero Lauriola, Carmelo Anile, Giulio Maira, Laura De Marinis Grasso

Research output: Contribution to journalArticle

35 Citations (Scopus)

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.
Original languageEnglish
Pages (from-to)267-276
Number of pages10
JournalPituitary
Volume17
DOIs
Publication statusPublished - 2014

Keywords

  • Adenoma
  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Female
  • Humans
  • Ki-67 Antigen
  • Male
  • Middle Aged
  • Pituitary Function Tests
  • Pituitary Neoplasms
  • Prognosis
  • Retrospective Studies
  • Young Adult

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