Tadokoro Kent, Wolf Colten, Toth Joseph, Joyce Cara, Singh Meharvan, Germanwala Anand, Patel Chirag
Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois, United States.
State University of New York Upstate Medical University, Syracuse, New York, United States.
J Neurol Surg B Skull Base. 2021 Sep 21;83(Suppl 2):e580-e590. doi: 10.1055/s-0041-1735874. eCollection 2022 Jun.
K -67/MIB-1 is a marker of cellular proliferation used as a pathological parameter in the clinical assessment of pituitary adenomas, where its expression has shown utility in predicting the invasiveness of these tumors. However, studies have shown variable results when using K -67/MIB-1 association with recurrence. The purpose of this study is to determine if a high K -67/MIB-1 labeling index (LI) is predictive of recurrence in pituitary adenomas. A retrospective chart review was performed for patients undergoing pituitary adenoma resection with at least 1 year of follow-up. Additionally, systematic data searches were performed and included studies that correlated recurrence rate to K -67/MIB-1 LI. Our institutional data were included in a synthesis with previously published data. Our institutional review included 79 patients with a recurrence rate of 26.6%. We found that 8.8% of our patients had a high K -67/MIB-1 LI (>3%); however, high K -67/MIB-1 was not associated with recurrence. The systematic review identified 244 articles and 49 full-text articles that were assessed for eligibility. Quantitative analysis was performed on 30 articles including our institutional data and 18 studies reported recurrence by level of K -67/MIB-1 LI. Among studies that compared K -67/MIB-1 ≥3 vs. <3%, 10 studies reported odds ratios (OR) greater than 1 of which 6 were statistically significant. A high K -67/MIB-1 had higher odds of recurrence via the pooled odds ratio (OR = 4.15, 95% confidence interval [CI]: 2.31-7.42). This systematic review suggests that a high K -67/MIB-1 should prompt an increased duration of follow-up due to the higher odds of recurrence of pituitary adenoma.
K-67/MIB-1是一种细胞增殖标志物，在垂体腺瘤的临床评估中用作病理参数，其表达已显示出在预测这些肿瘤侵袭性方面的效用。然而，研究表明，使用K-67/MIB-1与复发的关联时结果存在差异。本研究的目的是确定高K-67/MIB-1标记指数（LI）是否可预测垂体腺瘤的复发。
对接受垂体腺瘤切除术且随访至少1年的患者进行了回顾性病历审查。此外，还进行了系统的数据检索，纳入了将复发率与K-67/MIB-1 LI相关联的研究。我们机构的数据与先前发表的数据进行了综合。
我们机构的审查包括79例患者，复发率为26.6%。我们发现，8.8%的患者K-67/MIB-1 LI高（>3%）；然而，高K-67/MIB-1与复发无关。系统评价确定了244篇文章和49篇全文文章，并对其进行了资格评估。对30篇文章进行了定量分析，包括我们机构的数据，18项研究报告了按K-67/MIB-1 LI水平的复发情况。在比较K-67/MIB-1≥3%与<3%的研究中，10项研究报告的优势比（OR）大于1，其中6项具有统计学意义。通过合并优势比，高K-67/MIB-1的复发几率更高（OR = 4.15，95%置信区间[CI]：2.31 - 7.42）。
这项系统评价表明，由于垂体腺瘤复发几率较高，高K-67/MIB-1应促使延长随访时间。
