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Ko CC, Chen TY, Lim SW, Kuo YT, Wu TC, Chen JH. Prediction of recurrence in solid nonfunctioning pituitary macroadenomas: additional benefits of diffusion-weighted MR imaging. J Neurosurg 2020; 132:351-359. [PMID: 30717054 DOI: 10.3171/2018.10.jns181783] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 10/01/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE A subset of benign, nonfunctioning pituitary macroadenomas (NFMAs) has been shown to undergo early progression/recurrence (P/R) during the first years after surgical resection. The aim of this study was to determine preoperative MR imaging features for the prediction of P/R in benign solid NFMAs, with emphasis on apparent diffusion coefficient (ADC) values. METHODS We retrospectively investigated the preoperative MR imaging features for the prediction of P/R in benign solid NFMAs. Only the patients who had undergone preoperative MRI and postoperative MRI follow-ups for more than 1 year (at least every 6-12 months) were included. From November 2010 to December 2016, a total of 30 patients diagnosed with benign solid NFMAs were included (median follow-up time 45 months), and 19 (63.3%) patients had P/R (median time to P/R 24 months). RESULTS Benign solid NFMAs with cavernous sinus invasion, failed chiasmatic decompression, large tumor height and tumor volume, high diffusion-weighted imaging (DWI) signal, and lower ADC values/ratios were significantly associated with P/R (p < 0.05). The cutoff points of ADC value and ADC ratio for prediction of P/R are 0.77 × 10-3 mm2/sec and 1.01, respectively, with area under the curve (AUC) values (0.9 and 0.91) (p < 0.01). In multivariate Cox proportional hazards analysis, low ADC value (< 0.77 × 10-3 mm2/sec) is a high-risk factor of P/R (p < 0.05) with a hazard ratio of 14.07. CONCLUSIONS Benign solid NFMAs with low ADC values/ratios are at a significantly increased risk of P/R, and aggressive treatments accompanied by close follow-up with imaging studies should be considered.
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Affiliation(s)
- Ching-Chung Ko
- 1Section of Neuroradiology, Department of Medical Imaging, Chi-Mei Medical Center, Tainan
| | - Tai-Yuan Chen
- 1Section of Neuroradiology, Department of Medical Imaging, Chi-Mei Medical Center, Tainan
- 2Graduate Institute of Medical Sciences, Chang Jung Christian University, Tainan
| | - Sher-Wei Lim
- 3Department of Neurosurgery, Chi-Mei Medical Center, Chiali, Tainan
- 4Department of Nursing, Min-Hwei College of Health Care Management, Tainan
| | - Yu-Ting Kuo
- 1Section of Neuroradiology, Department of Medical Imaging, Chi-Mei Medical Center, Tainan
- 5Department of Radiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung
| | - Te-Chang Wu
- 1Section of Neuroradiology, Department of Medical Imaging, Chi-Mei Medical Center, Tainan
- 6Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei
| | - Jeon-Hor Chen
- 7Department of Radiology, E-DA Hospital, E-DA Cancer Hospital, I-Shou University, Kaohsiung, Taiwan; and
- 8Center for Functional Onco-Imaging of Radiological Sciences, School of Medicine, University of California, Irvine, California
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2
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Kudo T, Kamiie J, Aihara N, Doi M, Sumi A, Omachi T, Shirota K. Malignant Leydig cell tumor in dogs: two cases and a review of the literature. J Vet Diagn Invest 2019; 31:557-561. [PMID: 31248354 PMCID: PMC6857010 DOI: 10.1177/1040638719854791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Malignant Leydig cell tumor (MLCT) is a rare testicular tumor in dogs. We report herein 2 dogs with MLCT and cutaneous metastasis. Grossly, marked enlargement and distortion of the involved testes were noted; on cut surface, the parenchyma was completely replaced by neoplastic tissue. In addition, these tumors had extensive necrosis and hemorrhage. Case 1 had a rapidly growing cutaneous mass in the left angle of the mouth; the lesion was well-circumscribed and had an indistinct lobular pattern. Case 2 had multiple cutaneous masses in the dorsal neck region, the thoracic back region, and the right hindlimb. Microscopically, the tumor lobules were composed of oval-to-polyhedral cells with eosinophilic cytoplasm and resembled testicular tumors. By immunohistochemistry, the neoplastic cells in both the testicular and cutaneous tumors were positive for inhibin-alpha and melan A. The mitotic counts of the primary tumors from cases 1 and 2 were 21 and 11 per 10 high-power fields, respectively. Based on these findings, the cases were diagnosed as MLCT with cutaneous metastasis. Ki-67 expression in the neoplastic cells of the 2 cases was higher than in benign Leydig cell tumors. Our findings may be helpful for the diagnosis of canine MLCT.
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Affiliation(s)
- Tomoo Kudo
- PATHO LABO, Shizuoka, Japan
- Laboratory of Veterinary Pathology, School
of Veterinary Medicine, Azabu University, Kanagawa, Japan
| | - Junichi Kamiie
- PATHO LABO, Shizuoka, Japan
- Laboratory of Veterinary Pathology, School
of Veterinary Medicine, Azabu University, Kanagawa, Japan
| | - Naoyuki Aihara
- PATHO LABO, Shizuoka, Japan
- Laboratory of Veterinary Pathology, School
of Veterinary Medicine, Azabu University, Kanagawa, Japan
| | - Masaki Doi
- PATHO LABO, Shizuoka, Japan
- Laboratory of Veterinary Pathology, School
of Veterinary Medicine, Azabu University, Kanagawa, Japan
| | - Ayumi Sumi
- PATHO LABO, Shizuoka, Japan
- Laboratory of Veterinary Pathology, School
of Veterinary Medicine, Azabu University, Kanagawa, Japan
| | - Tetsuo Omachi
- PATHO LABO, Shizuoka, Japan
- Laboratory of Veterinary Pathology, School
of Veterinary Medicine, Azabu University, Kanagawa, Japan
| | - Kinji Shirota
- Kinji Shirota,
Laboratory of Veterinary Pathology, Azabu University, 1-17-71
Fuchinobe, Chuo-ku, Sagamihara, Kanagawa 252-5201, Japan.
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3
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Bălinişteanu B, Cîmpean AM, Ceauşu AR, Corlan AS, Melnic E, Raica M. High Ki-67 expression is associated with prolactin secreting pituitary adenomas. Bosn J Basic Med Sci 2017; 17:104-108. [PMID: 28432860 DOI: 10.17305/bjbms.2017.1750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 01/11/2017] [Accepted: 01/11/2017] [Indexed: 11/16/2022] Open
Abstract
Pituitary adenomas represent the third most common primary intracranial tumor in neurosurgical practice. To understand the biological behaviour of the pituitary adenomas previous studies have determined the tumor proliferation rate using monoclonal antibodies targeted against the Ki-67 antigen. The aim of this study was to correlate the Ki-67 index with hormonal profiles of pituitary adenomas. The study included 50 pituitary adenomas. For histopathologic evaluation, the sections were stained with routine hematoxylin and eosin method. Additional paraffin sections from each tumor were immunostained using primary antibodies against the following pituitary hormones: somatotropin (STH), prolactin (PRL), adrenocorticotrophic hormone (ACTH), thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH), and luteinizing hormone (LH). To detect the expression of Ki-67 we used a mouse anti-human monoclonal antibody (clone K2). The percentage of Ki-67 positive nuclei (Ki-67 labeling index) was assessed by counting approximately 1000 nuclei of the tumor cells at ×400 magnification. Out of the 50 tumor samples, 31 (62%) pituitary adenomas showed proliferative activity, and the proliferation rate was variable in this group. The overall mean Ki-67 labeling index was 1.59 ± 1.47, ranging from 0.3% to 6.6%. In 5 cases, the Ki-67 index was >3%, all of them being prolactinomas. The Ki-67 index was higher in PRL-secreting adenomas (mean ± SD was 3.37 ± 1.80, range 0.9 - 6.6%). Our study provides the evidence that a higher Ki-67 value is associated with pituitary adenomas that secrete PRL (prolactinomas and mixed STH/PRL-secreting adenomas).
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Affiliation(s)
- Bogdan Bălinişteanu
- Department of Microscopic Morphology/Histology, Angiogenesis Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
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Taschner CA, Sankowski R, Shah JM, Urbach H, Hartmann R, Prinz M. Freiburg Neuropathology Case Conference : A Pituitary Mass Lesion. Clin Neuroradiol 2016; 26:493-497. [PMID: 27830265 DOI: 10.1007/s00062-016-0549-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C A Taschner
- Department of Neuroradiology, University Medical Centre Freiburg, Freiburg, Germany.
| | - R Sankowski
- Department of Neuropathology, University Medical Centre Freiburg, Freiburg, Germany
| | - J M Shah
- Department of Neurosurgery, University Medical Centre Freiburg, Freiburg, Germany
| | - H Urbach
- Department of Neuroradiology, University Medical Centre Freiburg, Freiburg, Germany
| | - R Hartmann
- Department of Neuroradiology, University Medical Centre Freiburg, Freiburg, Germany
| | - M Prinz
- Department of Neuropathology, University Medical Centre Freiburg, Freiburg, Germany
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5
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Abstract
The sellar region is a tiny anatomic compartment in which many lesions and developmental diseases can be found. If pituitary adenomas represent most of the sellar mass, it is important to recognize other pathologic conditions before any surgical procedure, because the optimal treatment may differ considerably from one lesion to another. A careful clinical evaluation followed by neuroimaging studies and an endocrinologic and ophtalmologic workup will lead, in most cases, to a diagnosis with near certainty. This article provides an overview of sellar diseases with emphasis on their most useful characteristics for clinical practice.
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Affiliation(s)
- Damien Bresson
- Neurosurgery Department, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, Paris 75010, France
| | - Philippe Herman
- ENT Department, Lariboisière Hospital, Université Paris VII - Diderot, 2 rue Ambroise Paré, Paris 75010, France
| | - Marc Polivka
- Department of Pathology, Lariboisiere Hospital, 2 rue Ambroise Paré, Paris 75010, France
| | - Sébastien Froelich
- Neurosurgery Department, Assistance Publique-Hôpitaux de Paris, Université Paris VII - Diderot, 2 rue Ambroise Paré, Paris 75010, France.
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Alimohamadi M, Ownagh V, Mahouzi L, Ostovar A, Abbassioun K, Amirjmshidi A. The impact of immunohistochemical markers of Ki-67 and p53 on the long-term outcome of growth hormone-secreting pituitary adenomas: A cohort study. Asian J Neurosurg 2015; 9:130-6. [PMID: 25685203 PMCID: PMC4323896 DOI: 10.4103/1793-5482.142732] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The tumoral biomarkers have a rather well known effect upon the tumor control period of several types of malignant lesions. The aim of this study was to evaluate the impact of immunohistochemical (IHC) markers of Ki-67 and p53 on the long-term outcome of growth hormone (GH)-secreting pituitary adenomas treated surgically. MATERIALS AND METHODS We conducted and followed a cohort of 47 consecutive patients with GH-secreting pituitary adenomas referred to our department during a 4 year period for trans-sphenoidal microsurgical adenomectomy. The expression levels of Ki-67 and p53 were determined by IHC study of the tissue samples. Periodical pituitary magnetic resonance imaging (MRI), visual field studies and hormonal evaluations (GH and insulin-like growth factor-1 [IGF-1]) performed during the follow-up period were the outcome measures. RESULTS The level of Ki-67 expression was higher among patients with postoperative residual tumor (3.5 vs. 1.7%) and those with a hormonal recurrence (4.3 vs. 1.6%). The p53 expression level was remarkably higher in patients with radiological recurrence (18 vs. 6.3%). Patients with invasive features (i.e. cavernous sinus and suprasellar invasion) had significantly higher p53 and Ki-67 values and higher IGF-1 levels during the follow-up period. The patients younger than 30 years of age and those with mixed GH-prolactin secreting adenomas had significantly higher hormonal remission and lower radiological recurrence rates. CONCLUSION Each of the biomarkers, Ki-67 and p53, along with patient's age and mixed GH-prolactin secretion showed a kind of correlation with each of aspects of the clinical, hormonal and radiologic outcome of GH-secreting pituitary adenomas in this series.
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Affiliation(s)
- Maysam Alimohamadi
- Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Ownagh
- Department of Neurosurgery, Sina Hospital Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Mahouzi
- Department of Endocrinology, Arad Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- The Persian Gulf Infectious Diseases and Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Kazem Abbassioun
- Department of Neurosurgery, Arad Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Amirjmshidi
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Hadzhiyanev A, Ivanova R, Nachev E, Elenkova A, Yaneva M, Zaharieva S, Marinov M, Surchev J, Ivanova A. Evaluation of prognostic utility of MIB-1 and p53 expression in pituitary adenomas: correlations with clinical behaviour and follow-up results. BIOTECHNOL BIOTEC EQ 2014; 28:502-507. [PMID: 26019536 PMCID: PMC4433927 DOI: 10.1080/13102818.2014.932510] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 01/31/2014] [Indexed: 11/15/2022] Open
Abstract
Pituitary adenomas (PAs) show a broad clinicomorphological spectrum. The proliferation activity, evaluated by MIB-1 labelling index (LI), and p53 expression have been pointed as predictive markers for invasiveness and progression. The aim of this study was to evaluate the proliferation rate and p53 expression and to look for any relationships with the clinical behaviour and follow-up results in a series of Bulgarian patients with PAs. A total of 93 patients with PAs (81 hormone-secreting, 12 non-functioning), who were operated on and followed up for a period of five years, were included. The MIB-1 LI and p53 expressions were determined by immunohistochemistry and correlated with various clinical and tumour variables. The whole group of PAs showed a low proliferation rate with evident variations in a small number of cases (MIB-1 LI – 0.50 ± 0.56, from 0.1 to 3.30). MIB-1 LI correlated with tumour size (p = 0.012) and was positively related with male gender (p = 0.23) and partial surgical resection (p = 0.036). We found no significant differences regarding the age, functional activity, invasion (n = 33), expansion (n = 37) and tumour recurrences (seven cases). Only 10 cases (10.8%) showed a focal, nuclear p53 immunoreactivity. The p53 positive tumours had higher proliferation rate (p = 0.0001) but no relationship with the other clinical and tumour variables. Among all cases, there was only one case with higher MIB-1 LI (3.3%), positive p53 expression and tumour recurrence after surgery. Our results show that most PAs have a low proliferation rate and lack of p53 expression, as well as no relationship with tumour invasion or postsurgical progression.
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Affiliation(s)
- Asen Hadzhiyanev
- Department of Neurosurgery, University Hospital 'St. Ivan Rilsky', Medical University of Sofia , Sofia , Bulgaria
| | - Radina Ivanova
- Clinical Center of Endocrinology and Gerontology, Medical University of Sofia , Sofia , Bulgaria
| | - Emil Nachev
- Clinical Center of Endocrinology and Gerontology, Medical University of Sofia , Sofia , Bulgaria
| | - Atanaska Elenkova
- Clinical Center of Endocrinology and Gerontology, Medical University of Sofia , Sofia , Bulgaria
| | - Maria Yaneva
- Clinical Center of Endocrinology and Gerontology, Medical University of Sofia , Sofia , Bulgaria
| | - Sabina Zaharieva
- Clinical Center of Endocrinology and Gerontology, Medical University of Sofia , Sofia , Bulgaria
| | - Marin Marinov
- Department of Neurosurgery, University Hospital 'St. Ivan Rilsky', Medical University of Sofia , Sofia , Bulgaria
| | - Jivko Surchev
- Department of Neurosurgery, University Hospital 'St. Ivan Rilsky', Medical University of Sofia , Sofia , Bulgaria
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8
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Monsalves E, Larjani S, Loyola Godoy B, Juraschka K, Carvalho F, Kucharczyk W, Kulkarni A, Mete O, Gentili F, Ezzat S, Zadeh G. Growth patterns of pituitary adenomas and histopathological correlates. J Clin Endocrinol Metab 2014; 99:1330-8. [PMID: 24423330 DOI: 10.1210/jc.2013-3054] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The factors associated with pituitary adenoma (PA) growth rate remain unclear. OBJECTIVE The objective of the study was to establish whether the preoperative growth and extension pattern of PA can predict postoperative growth rate and recurrence in addition to whether the PA growth rate correlates with proliferation and growth factor expression. PATIENTS One hundred fifty-three consecutive patients who underwent surgery for pituitary adenoma from 1999 to 2011 at Toronto Western Hospital were identified. MAIN OUTCOME MEASURES The PA growth rate was measured both pre- and postoperatively, and its association with patient demographics, magnetic resonance imaging, and histolopathological parameters was determined. RESULTS The preoperative growth rate was associated with age (P = .0001), suprasellar growth (P = .003), the presence of a cyst/hemorrhage (P = .004), the mindbomb homolog-1 (P = .005), fibroblast growth factor receptor-4 positivity (P = .047), and p27 negativity (P = .007). After surgery, there were 34.6% residual volumes, which were associated with older age (P = .038) and also with growth patterns including anterior, posterior, suprasellar, and cavernous sinus extension (P = .001); 43.3% of these residuals grew and postoperative growth rate was calculated. Pre- and postoperative growth rates were correlated (r = 0.497, P = .026). Postoperative growth rate was associated with age (P = .015) and gender (P = .017). CONCLUSIONS Our data suggest that the growth rate of PAs are influenced by various patient- and tumor-specific characteristics including the age and sex of the patient, the specific subtype of PA, its hormonal activity, its immunohistochemical profile including the mindbomb homolog 1 labeling index status, and its preponderance for different growth directions relative to the pituitary fossa. Furthermore, the pre- and postoperative PA growth rates were correlated, suggesting that postoperative PA growth rates can be predicted, in part, by preoperative growth rates, thus better informing postoperative outcome.
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Affiliation(s)
- Eric Monsalves
- Institute of Medical Science (E.M., S.E., G.Z.) and Department of Laboratory Medicine and Pathobiology (O.M.), University of Toronto, Toronto, Canada M5T 2S8; Divisions of Neurosurgery (E.M., S.L., B.L.G., K.J., F.C., F.G., G.Z.) and Division of Radiology (W.K.), and Departments of Medicine (S.E.) and Pathology (O.M.), University Health Network, Toronto, Canada M5G 2C4; and Division of Neurosurgery (A.K.), Hospital for Sick Children, Toronto, Canada M5G 1X8
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9
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Hlavica M, Bellut D, Lemm D, Schmid C, Bernays RL. Impact of Ultra-Low-Field Intraoperative Magnetic Resonance Imaging on Extent of Resection and Frequency of Tumor Recurrence in 104 Surgically Treated Nonfunctioning Pituitary Adenomas. World Neurosurg 2013; 79:99-109. [DOI: 10.1016/j.wneu.2012.05.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2011] [Revised: 04/01/2012] [Accepted: 05/15/2012] [Indexed: 11/27/2022]
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10
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Hightower E, Cabanillas ME, Fuller GN, McCutcheon IE, Hess KR, Shah K, Waguespack SG, Corley LJ, Devin JK. Phospho-histone H3 (pHH3) immuno-reactivity as a prognostic marker in non-functioning pituitary adenomas. Pituitary 2012; 15:556-61. [PMID: 22120760 PMCID: PMC3852837 DOI: 10.1007/s11102-011-0367-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Nonfunctioning pituitary adenomas (NFPA) are typically benign neoplasms that can cause significant morbidity through local mass effects. MIB-1/Ki-67 and p53 immuno-reactivity are used to predict aggressive behavior but have known limitations. No marker to date is widely used to reliably predict tumor progression. Phospho-histone H3 (pHH3) is a protein phosphorylated during chromatin condensation in mitosis, and thus anti-pHH3 immunocytochemistry is able to assess mitotic activity. Study objectives were to determine the relationship among pHH3, MIB-1/Ki-67, and p53 in NFPA, and to evaluate the relationship between these indices and time to progression (TTP). Seventy-six patients with NFPA operated on by a single neurosurgeon at University of Texas M. D. Anderson Cancer Center from 1992 to 2006 were identified from a database and met all criteria for inclusion in this clinicopathology study. PHH3, MIB-1/Ki-67, and p53 immuno-reactivity was evaluated in each case. Retrospective review was used to determine TTP. With 282 person-years of follow-up, 19 progression events were observed. A correlation was found between MIB-1/Ki-67 and p53 immuno-reactivity (r = 0.25, p = 0.031). PHH3 did not correlate with either. When markers were dichotomized at the median, only MIB-1/Ki-67 correlated with TPP (log rank p = 0.018). Rank correlation analysis confirmed a significant inverse correlation between both MIB-1/Ki-67 (Dxy = -0.33, p = 0.036) and p53 (Dxy = -0.40, 0.016) immuno-reactivity and TTP. Our results support previous data suggesting that MIB-1/Ki-67 and p53 have clinical utility as prognostic markers for tumor progression. PHH3 did not prove to be associated with TTP in this retrospective study limited by few progression events.
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Affiliation(s)
- Erica Hightower
- Endocrinology, University of Texas Medical School at Houston, Houston, TX, USA
| | - Maria E. Cabanillas
- Division of Endocrine Neoplasia & Hormonal Disorders, Univeristy of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Greg N. Fuller
- Pathology, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Ian E. McCutcheon
- Neurosurgery, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Kenneth R. Hess
- Biostatistics, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Komal Shah
- Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Steven G. Waguespack
- Division of Endocrine Neoplasia & Hormonal Disorders, Univeristy of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Lynda J. Corley
- Pathology, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Jessica K. Devin
- Division of Endocrine Neoplasia & Hormonal Disorders, Univeristy of Texas M. D. Anderson Cancer Center, Houston, TX, USA
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11
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Salehi F, Agur A, Scheithauer BW, Kovacs K, Lloyd RV, Cusimano M. Ki-67 in pituitary neoplasms: a review--part I. Neurosurgery 2009; 65:429-37; discussion 437. [PMID: 19687686 DOI: 10.1227/01.neu.0000349930.66434.82] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
KI-67, A MARKER of cellular proliferation, has been studied extensively in pituitary neoplasia. It is of relevance to various clinicopathological parameters, including tumor subtype, size, invasiveness, and recurrence, as well as patient age and sex. Generally, pituitary tumors behaving aggressively have increased Ki-67 labeling indices. Nonetheless, there is considerable overlap in Ki-67 labeling between noninvasive and invasive adenomas as well as between adenomas and pituitary carcinomas. Not only is there no general agreement regarding the relationship of Ki-67 labeling index and tumor invasiveness, but the same is also true of the association with pituitary tumor size, growth fraction, and recurrence. Whereas a number of studies found conclusive associations of Ki-67 labeling indices with aggressive behavior, size, and/or adenoma subtype, others fail to do so. It is evident that discrepant data regarding tumor behavior in part has its basis in nonuniform study criteria. For example, different investigators use varying criteria of tumor invasion and recurrence. Herein, we review the literature relating Ki-67 expression and various other clinicopathological parameters and conclude that uniform definitions and methods, as well as new markers, are key to improved treatment of pituitary tumors.
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Affiliation(s)
- Fateme Salehi
- Department of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, Canada
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