Losa M, Franzin A, Mangili F, Terreni M R, Barzaghi R, Veglia F, Mortini P, Giovanelli M
Department of Neurosurgery, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele, University of Milan, Italy.
Neurosurgery. 2000 Dec;47(6):1313-8; discussion 1318-9.
The recurrence of nonfunctioning pituitary adenomas (NFPAs) after surgical removal is common. The aim of our study was to investigate and correlate the growth fraction of NFPAs with clinical characteristics and long-term follow-up results.
Tumor specimens were obtained from 101 consecutive patients with NFPAs (48 female patients and 53 male patients; mean age, 52.0 +/- 1.5 yr). Specimens were immediately fixed in 10% buffered formalin and then embedded in paraffin. The Ki-67 antigen was assessed by immunocytochemical analysis using the monoclonal antibody MIB-1. The Ki-67 antigen labeling index (LI) was determined by counting a total of at least 1,000 neoplastic nuclei.
The mean Ki-67 LI for the 101 patients was 2.4 +/- 0.3% (range, 0-23.0%). Only age at surgery was inversely correlated with the Ki-67 LI; sex, maximal tumor diameter, and invasiveness into the cavernous sinuses did not significantly affect the Ki-67 LI. The mean follow-up period was 39.7 +/- 2.1 months. During follow-up monitoring, 23 patients experienced tumor recurrence, after a mean period of 28.6 +/- 4.8 months. Invasiveness of the tumor on preoperative magnetic resonance imaging scans was the strongest predictor of late tumor recurrence, followed by previous pituitary surgery, younger age, and lack of postoperative radiotherapy. The Ki-67 LI had no independent prognostic value.
Our study suggests that the clinical characteristics of patients with NFPAs, except for age at surgery, are not correlated with the Ki-67 LI. Moreover, the Ki-67 LI does not seem to provide independent information to identify patients at high risk for tumor recurrence.
无功能垂体腺瘤（NFPAs）手术切除后复发很常见。本研究的目的是调查NFPAs的生长分数，并将其与临床特征及长期随访结果相关联。
从101例连续的NFPAs患者（48例女性患者和53例男性患者；平均年龄52.0±1.5岁）获取肿瘤标本。标本立即固定于10%缓冲福尔马林中，然后石蜡包埋。使用单克隆抗体MIB-1通过免疫细胞化学分析评估Ki-67抗原。通过计数至少1000个肿瘤细胞核来确定Ki-67抗原标记指数（LI）。
101例患者的平均Ki-67 LI为2.4±0.3%（范围0-23.0%）。仅手术年龄与Ki-67 LI呈负相关；性别、肿瘤最大直径及海绵窦侵袭性对Ki-67 LI无显著影响。平均随访期为39.7±2.1个月。在随访监测期间，23例患者出现肿瘤复发，平均复发时间为28.6±4.8个月。术前磁共振成像扫描显示的肿瘤侵袭性是晚期肿瘤复发的最强预测因素，其次是既往垂体手术、年轻及术后未行放疗。Ki-67 LI无独立的预后价值。
我们的研究表明，除手术年龄外，NFPAs患者的临床特征与Ki-67 LI无关。此外，Ki-67 LI似乎无法提供独立信息以识别肿瘤复发高危患者。
