Mastronardi L, Guiducci A, Spera C, Puzzilli F, Liberati F, Maira G
Department of Neurological Sciences, Civilian Hospital, Terni, Italy.
J Clin Pathol. 1999 Feb;52(2):107-11. doi: 10.1136/jcp.52.2.107.
To investigate the relation between proliferative activity of anterior pituitary adenomas, quantified by the Ki-67 labelling index, and their invasive behaviour.
Expression of Ki-67 was evaluated in 103 anterior pituitary adenomas consecutively operated on in a 36 month period and correlated with surgical evidence of invasiveness.
Non-invasive (n = 65) and invasive (n = 38) adenomas were identified from surgically verified infiltration of sellar floor dura and bone. The wall of the cavernous sinus was infiltrated in 16 cases. Forty one adenomas were non-functioning and 62 functioning (24 prolactin, 21 growth hormone, 10 ACTH, seven mixed). The overall mean (SD) Ki-67 labelling index was 2.64 (3.69) per cent (median 1.5). The mean index was 3.08 (4.59) per cent in functioning and 1.97 (1.78) per cent in non-functioning tumours; 5.47 (9.52) per cent in ACTH adenomas and 2.33 (2.42) per cent in others (p = 0.01); 3.71 (5.17) per cent in invasive and 2.01 (2.45) per cent in non-invasive adenomas (p = 0.027); and 5.58 (7.24) per cent in cavernous sinus infiltrating v 2.10 (2.39) per cent in cavernous sinus non-infiltrating adenomas (p = 0.0005). To identify a value of labelling index beyond which adenomas should be considered invasive and another beyond which cavernous sinus infiltration should be suspected, normality Q-Q plots were obtained: a threshold labelling index of 3.5% for invasive adenomas and of 5% for cavernous sinus infiltrating adenomas was defined, with statistically significant differences (p = 0.02 and p = 0.004, respectively).
The Ki-67 labelling index can be considered a useful marker in determining the invasive behaviour of anterior pituitary adenomas.
通过Ki-67标记指数对垂体前叶腺瘤的增殖活性进行量化，并研究其与侵袭行为之间的关系。
对在36个月期间连续接受手术的103例垂体前叶腺瘤进行Ki-67表达评估，并将其与侵袭性的手术证据相关联。
根据手术证实的鞍底硬脑膜和骨质浸润情况，确定了非侵袭性（n = 65）和侵袭性（n = 38）腺瘤。16例海绵窦壁受到浸润。41例腺瘤无功能，62例有功能（24例泌乳素瘤、21例生长激素瘤、10例促肾上腺皮质激素瘤、7例混合性肿瘤）。Ki-67标记指数的总体平均（标准差）为2.64（3.69）%（中位数为1.5）。有功能肿瘤的平均指数为3.08（4.59）%，无功能肿瘤为1.97（1.78）%；促肾上腺皮质激素瘤为5.47（9.52）%，其他肿瘤为2.33（2.42）%（p = 0.01）；侵袭性腺瘤为3.71（5.17）%，非侵袭性腺瘤为2.01（2.45）%（p = 0.027）；海绵窦浸润性腺瘤为5.58（7.24）%，海绵窦非浸润性腺瘤为2.10（2.39）%（p = 0.0005）。为确定标记指数超过何值时腺瘤应被视为侵袭性，以及超过何值时应怀疑海绵窦浸润，绘制了正态QQ图：定义侵袭性腺瘤的标记指数阈值为3.5%，海绵窦浸润性腺瘤为5%，差异具有统计学意义（分别为p = 0.02和p = 0.004）。
Ki-67标记指数可被视为确定垂体前叶腺瘤侵袭行为的有用标志物。
