Petry Carolina, Poli Jefferson Henrique Zwir, de Azevedo Dossin Isabella, Rech Carolina Garcia Soares Leães, Pereira Lima Júlia Fernanda Semmelmann, Ferreira Nelson Pires, da Costa Oliveira Miriam
Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA) Porto Alegre, RS, Brazil.
Neuroendocrinology Center, Santa Casa of Porto Alegre/UFCSPA Porto Alegre, RS, Brazil.
Int J Clin Exp Pathol. 2019 Jan 1;12(1):320-326. eCollection 2019.
The aggressive course of a number of pituitary adenomas requires the investigation of potential predictors. This study aimed to investigate the proliferation marker Ki67 as a predictor of postoperative outcome in patients with pituitary adenoma regarding recurrence and regrowth of the tumor, using a Ki67 cut-off value of 3%. This retrospective study included 52 patients with pituitary adenoma who had undergone adenomectomy and had a pituitary image taken at least 1 year after surgery. Patients were divided according to Ki67 expression into high (≥3%) vs. low (<3%) levels of Ki67. The two groups were similar regarding the preoperative tumor invasion grade. The Ki67 index ranged from 0 to 30%; in 23 cases, Ki67 was ≥3%. The two groups were similar regarding tumor recurrence and regrowth: 4 cases (28%) of recurrence in the Ki67<3% group vs. none in the Ki67≥3% group (P=0.26); and 2 cases (13%) of regrowth in the Ki67<3% group vs. 7 cases (43%) in the Ki67≥3% group (P=0.11). A subgroup analysis was performed for nonfunctioning adenomas. Recurrence rates remained similar between groups (Ki67<3% group: 1 case [20%]; Ki67≥3% group: none; P>0.99), whereas regrowth rates were higher in the Ki67≥3% group (6 cases [67%] vs. 2 cases [17%] in the Ki67<3% group; P=0.03). The patient with the highest Ki67 index (30%) developed pituitary carcinoma. The results allow us to suggest the adoption of a stricter control of image monitoring in nonfunctioning adenomas with incomplete resection associated with a Ki67 index ≥3%.
一些垂体腺瘤的侵袭性病程需要对潜在预测因素进行研究。本研究旨在研究增殖标志物Ki67作为垂体腺瘤患者术后肿瘤复发和再生长结局的预测指标，采用的Ki67临界值为3%。这项回顾性研究纳入了52例接受腺瘤切除术且术后至少1年进行过垂体影像学检查的垂体腺瘤患者。根据Ki67表达将患者分为Ki67高表达（≥3%）组和低表达（<3%）组。两组在术前肿瘤侵袭分级方面相似。Ki67指数范围为0至30%；23例患者的Ki67≥3%。两组在肿瘤复发和再生长方面相似：Ki67<3%组有4例（28%）复发，而Ki67≥3%组无复发（P=0.26）；Ki67<3%组有2例（13%）再生长，而Ki67≥3%组有7例（43%）再生长（P=0.11）。对无功能腺瘤进行了亚组分析。两组之间的复发率仍然相似（Ki67<3%组：1例[20%]；Ki67≥3%组：无；P>0.99），而Ki67≥3%组的再生长率更高（Ki67≥3%组为6例[67%]，而Ki67<3%组为2例[17%]；P=0.03）。Ki67指数最高（30%）的患者发生了垂体癌。这些结果使我们建议，对于Ki67指数≥3%且切除不完全的无功能腺瘤，应采取更严格的影像监测控制措施。
