Department for Neurosurgery, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.
Institute of Pathology and Neuropathology, Department of Neuropathology, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.
Acta Neurochir (Wien). 2019 Jun;161(6):1149-1156. doi: 10.1007/s00701-019-03879-4. Epub 2019 Apr 30.
It is still controversial whether an increased proliferation index is correlated with the tumor invasiveness of pituitary adenomas. A homogeneous large monocentric series of pituitary adenomas was retrospectively analyzed. The correlation between the proliferation indices (Ki-67 and p53 expression levels) and invasiveness and size of pituitary adenomas was investigated in primary operated and recurrent adenomas.
Four hundred thirty-nine patients after resection of pituitary adenomas were retrospectively included (43 recurrent tumors, 196 null cell adenomas, 86 somatotroph adenomas, 55 corticotroph adenomas, 55 prolactinomas, 4 thyreotroph adenomas). The maximum tumor diameter and tumor invasiveness in Knosp grading were assessed and Ki-67 and p53 immunostaining was performed. The role of invasiveness was evaluated using a cumulative odds ordinal logistic regression. For calculating the effect of tumor size, a one-way analysis of variance (ANOVA) was conducted.
Overall and in the subgroups, no significant correlation between proliferation indices and mean tumor diameter was found. No significant predictive expression value of Ki-67 and p53 on tumor invasiveness and in recurrent tumors could be demonstrated. There was a tendency that Ki-67 LI and p53 LI are higher in recurrent corticotroph adenomas and lactotroph adenomas but values did not reach the significant level.
Invasive character of pituitary adenomas is neither correlated with increased Ki-67 LI nor with increased p53 expression. Proliferation parameters are independent from adenoma size at initial presentation. The partly elevated expression of Ki-67 in recurrent tumors underlines the clinical importance of the marker.
增殖指数是否与垂体腺瘤的侵袭性相关仍存在争议。本研究回顾性分析了一组均质的大型垂体腺瘤。研究了原发性和复发性垂体腺瘤中增殖指数（Ki-67 和 p53 表达水平）与侵袭性和大小的相关性。
共纳入 439 例接受垂体腺瘤切除术的患者（43 例复发性肿瘤、196 例无分泌功能腺瘤、86 例生长激素腺瘤、55 例促肾上腺皮质激素腺瘤、55 例催乳素腺瘤、4 例促甲状腺素腺瘤）。评估最大肿瘤直径和 Knosp 分级的肿瘤侵袭性，并进行 Ki-67 和 p53 免疫组化染色。使用累积优势有序逻辑回归评估侵袭性的作用。为了计算肿瘤大小的影响，进行了单向方差分析（ANOVA）。
总体而言，在各亚组中，增殖指数与平均肿瘤直径之间均无显著相关性。Ki-67 和 p53 的表达水平对肿瘤侵袭性和复发性肿瘤均无显著的预测价值。Ki-67 LI 和 p53 LI 在复发性促肾上腺皮质激素腺瘤和催乳素腺瘤中较高，但无统计学意义。
垂体腺瘤的侵袭性与 Ki-67 LI 的增加或 p53 表达的增加无关。增殖参数与初始表现时的腺瘤大小无关。Ki-67 在复发性肿瘤中的部分升高突显了该标志物的临床重要性。
