Residual nonfunctioning pituitary adenomas: prognostic value of MIB-1 labeling index for tumor progression

2009 ◽  
Vol 111 (3) ◽  
pp. 563-571 ◽  
Author(s):  
Georg Widhalm ◽  
Stefan Wolfsberger ◽  
Matthias Preusser ◽  
Ingeborg Fischer ◽  
Adelheid Woehrer ◽  
...  
Keyword(s):  
Tumor Progression ◽  
Pituitary Adenomas ◽  
Residual Tumor ◽  
Labeling Index ◽  
Ki 67 ◽  
Nonfunctioning Pituitary Adenomas ◽  
Time Period ◽  
Tumor Group ◽  
Significant Difference ◽  
Mib 1

Object In residual nonfunctioning pituitary adenomas, reliable prognostic parameters indicating probability of tumor progression are needed. The Ki 67 expression/MIB-1 labeling index (LI) is considered to be a promising candidate factor. The aim in the present study was to analyze the clinical usefulness of MIB-1 LI for prognosis of tumor progression. Methods The authors studied a cohort of 92 patients with nonfunctioning pituitary adenomas. Based on sequential postoperative MR images, patients were classified as tumor free (51 patients) or as harboring residual tumor (41 individuals). The residual tumor group was further subdivided in groups with stable residual tumors (14 patients) or progressive residual tumors (27 patients). The MIB-1 LI was assessed in tumor specimens obtained in all patients, and statistical comparisons of MIB-1 LI of the various subgroups were performed. Results . The authors found no significant difference of MIB-1 LI in the residual tumor group compared with the tumor-free group. However, MIB-1 LI was significantly higher in the progressive residual tumor group, compared with the stable residual tumor group. Additionally, the time period to second surgery was significantly shorter in residual adenomas showing an MIB-1 LI > 3%. Conclusions The data indicate that MIB-1 LI in nonfunctioning pituitary adenomas is a clinically useful prognostic parameter indicating probability of progression of postoperative tumor remnants. The MIB-1 LI may be helpful in decisions of postoperative disease management (for example, frequency of radiographic intervals, planning for reoperation, radiotherapy, and/or radiosurgery).

The Past, Present, and Future Statuses of Formerly Classified “Atypical Pituitary Adenomas”: A Clinicopathological Assessment of 101 Cases in a Cohort of More than 1,000 Pure Endoscopically Treated Patients in Single Center

2020 ◽  
Author(s):  
Ercan Bal ◽  
İbrahim Kulaç ◽  
Selim Ayhan ◽  
Figen Söylemezoğlu ◽  
Mustafa Berker
Keyword(s):  
Pituitary Adenomas ◽  
Labeling Index ◽  
World Health ◽  
Pituitary Neoplasms ◽  
Ki 67 ◽  
Cavernous Sinus Invasion ◽  
Atypical Adenoma ◽  
Endocrine Organs ◽  
Significant Difference ◽  
Cure Rates

Abstract Aim This study was aimed to assess the clinical aggressiveness of pituitary neoplasms that were previously defined as atypical adenomas. Methods A total of 1,042 pituitary adenomas were included in the study and 101 of them were diagnosed as atypical adenoma. Demographic characteristics, radiological evaluations, and clinical information were obtained from a computer-based patient database. Cases were categorized as atypical or typical using the criteria listed in 2004 Classification of Tumors of Endocrine Organs. Results The cure and reoperation rates did not show any statistically significant difference between the typical and atypical adenomas. However, a higher Ki-67 labeling index was found to be associated with a higher rate of reoperation (p = 0.008) in atypical adenomas. Of note, cavernous sinus invasion or parasellar extension was found to be associated with lower cure rates in patients with atypical pituitary adenomas (p < 0.001 and p = 0.001, respectively). Conclusion Although atypical pituitary adenomas are known to be more invasive, this study demonstrated that the reoperation and cure rates are the same for typical and atypical adenomas. Our findings advocate for omitting the use of atypical adenoma terminology based solely on pathological evaluation. As stated in the 4th edition of the World Health Organization (WHO) classification, accurate tumor subtyping, evaluation of proliferation by means of mitotic count and Ki-67 labeling index, and radiological and intraoperative assessments of tumor invasion should be taken into consideration in the management of such neoplasms.

Growth pattern and rate in residual nonfunctioning pituitary adenomas: correlations among tumor volume doubling time, patient age, and MIB-1 index

2003 ◽  
Vol 98 (2) ◽  
pp. 359-365 ◽  
Author(s):  
Yuichiro Tanaka ◽  
Kazuhiro Hongo ◽  
Tsuyoshi Tada ◽  
Keiichi Sakai ◽  
Yukinari Kakizawa ◽  
...  
Keyword(s):  
Pituitary Adenomas ◽  
Tumor Volume ◽  
Inverse Correlation ◽  
Residual Tumor ◽  
Patient Age ◽  
Content Type ◽  
Patient Âgé ◽  
Significant Difference ◽  
Fine Print ◽  
Mib 1

Object. Surgical cure can be achieved in pituitary adenomas when they are completely removed. It is controversial whether postoperative radiation therapy should be given to prevent recurrence, and whether an early reoperation should be performed for residual adenomas, because we have little information about the natural history of postoperative residual adenomas. Methods. The residual tumor volume was serially measured in 40 nonfunctioning pituitary adenomas (NFPAs) and the tumor volume doubling time (TVDT) was calculated. Correlations between the patients' age, tumor volume, log TVDT, and MIB-1 index were examined. Other factors including the patient's sex, cavernous sinus (CS) invasion by the tumor, or presence of an intratumoral cyst were analyzed to assess their influence on the TVDT. Values are expressed as the means ± standard deviations. Thirty-eight adenomas increased in volume and two decreased during a follow-up period ranging from 4 to 141 months (mean 52.5 months). Exponentially linear tumor growth was observed in the 38 growing adenomas regardless of the residual tumor volume, with the TVDT ranging from 506 to 5378 days (mean 1836 days). The patients' age was 57.1 ± 15.7 years (range 15–79 years), the tumor volume at the beginning of the magnetic resonance imaging observation period was 2.5 ± 2.2 cm3 (range 0.07–14.5 cm3), and the MIB-1 index was 0.73 ± 0.68% (range 0.1–2.9%). There was a correlation between the log TVDT and patient age (R = 0.73), an inverse correlation between the log TVDT and MIB-1 index (r = −0.49), and an inverse correlation between the MIB-1 index and patient age (r = −0.61). A significant difference (p = 0.0001) was noted between the TVDT (1106 days) in the 19 patients younger than 61 years of age and the TVDT (2566 days) in the 19 patients who were 61 years of age or older. There was also a significant difference (p = 0.0002) between the age (50.8 ± 15.3 years) of the patients with rapidly growing tumors (TVDT < 1836 days, 24 patients) and the age (69.1 ± 7.6 years) of the patients with slowly growing tumors (TVDT > 1836 days, 14 patients). Other factors including the patients' sex, CS invasion, and intratumoral cyst formation did not affect the TVDT of residual NFPAs. Conclusions. The tumor growth rate of residual NFPAs is strongly influenced by the patient's age. The TVDT in elderly patients is much longer than that previously reported. Treatment strategies that take into consideration the natural history of residual adenomas should be established especially in the elderly population.

Nonfunctioning pituitary adenomas: association of Ki-67 and HMGA-1 labeling indices with residual tumor growth

2014 ◽  
Vol 156 (3) ◽  
pp. 451-461 ◽  
Author(s):  
Andrej Šteňo ◽  
Jozef Bocko ◽  
Boris Rychlý ◽  
Martin Chorváth ◽  
Peter Celec ◽  
...  
Keyword(s):  
Tumor Growth ◽  
Pituitary Adenomas ◽  
Residual Tumor ◽  
Ki 67 ◽  
Nonfunctioning Pituitary Adenomas

scholarly journals Ki-67 labeling index and Knosp classification of pituitary adenomas

2021 ◽  
pp. 1-5
Author(s):  
Li Yuhan ◽  
Wu Zhiqun ◽  
Tian Jihui ◽  
Pan Renlong
Keyword(s):  
Pituitary Adenomas ◽  
Labeling Index ◽  
Ki 67

Ki-67/MIB-1 and Recurrence in Pituitary Adenoma

2021 ◽  
Author(s):  
Kent Tadokoro ◽  
Colten Wolf ◽  
Joseph Toth ◽  
Cara Joyce ◽  
Meharvan Singh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pituitary Adenoma ◽  
Recurrence Rate ◽  
Pituitary Adenomas ◽  
Cellular Proliferation ◽  
Published Data ◽  
Ki 67 ◽  
Institutional Data ◽  
Mib 1

Abstract Objectives Ki-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 Ki-67/MIB-1 association with recurrence. The purpose of this study is to determine if a high Ki-67/MIB-1 labeling index (LI) is predictive of recurrence in pituitary adenomas. Methods 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 Ki-67/MIB-1 LI. Our institutional data were included in a synthesis with previously published data. Results Our institutional review included 79 patients with a recurrence rate of 26.6%. We found that 8.8% of our patients had a high Ki-67/MIB-1 LI (>3%); however, high Ki-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 Ki-67/MIB-1 LI. Among studies that compared Ki-67/MIB-1 ≥3 vs. <3%, 10 studies reported odds ratios (OR) greater than 1 of which 6 were statistically significant. A high Ki-67/MIB-1 had higher odds of recurrence via the pooled odds ratio (OR = 4.15, 95% confidence interval [CI]: 2.31–7.42). Conclusion This systematic review suggests that a high Ki-67/MIB-1 should prompt an increased duration of follow-up due to the higher odds of recurrence of pituitary adenoma.

scholarly journals Factors That Predict the Growth of Residual Nonfunctional Pituitary Adenomas: Correlations between Relapse and Cell Cycle Markers

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Petr Matoušek ◽  
Petr Buzrla ◽  
Štefan Reguli ◽  
Jan Krajča ◽  
Jana Dvořáčková ◽  
...  
Keyword(s):  
Protein Expression ◽  
Pituitary Adenomas ◽  
Clinical Symptoms ◽  
Statistical Significance ◽  
Residual Tumor ◽  
Partial Resection ◽  
Ki 67 ◽  
Increased Risk ◽  
Nonfunctional Pituitary Adenomas ◽  
Remnant Tumor

Introduction. Nonfunctional pituitary adenomas are treated surgically, and even partial resection can improve or eliminate clinical symptoms. Notably, progression requires further intervention, which presents an increased risk, especially in older patients. This study investigated whether the histopathological characteristics of nonfunctional adenomas could predict recurrence. Materials and Methods. Data were obtained retrospectively from 30 patients who underwent surgery for the partial resection of pituitary adenomas. Remnant tumor growth was observed in 17 patients, while the residual tumor was unchanged more than 7 years after surgery in 13 patients. Statistical analysis was performed to investigate correlations between remnant tumor progression and tumor histopathological findings, including protein expression of p21, p27, p53, and Ki-67. Results and Discussion. Remnant tumors that demonstrated regrowth showed significantly higher protein expression of p21 and Ki-67. Expression of the p53 tumor suppressor was also higher in this group, but the difference was at the limit of statistical significance. Conclusion. Tumors with high expression of p21 and p53 and with a high Ki-67 index were more likely to show residual pituitary adenoma progression. Such cases should undergo frequent radiological examination and timely reoperation, and radiosurgery should be considered.

scholarly journals MIB-1 labeling index, Ki-67, is an indicator of invasive intraductal papillary mucinous neoplasm

2016 ◽  
Vol 5 (2) ◽  
pp. 317-322 ◽  
Author(s):  
Tatsuo Shimura ◽  
Yasuhide Kofunato ◽  
Ryo Okada ◽  
Rei Yashima ◽  
Koji Okada ◽  
...  
Keyword(s):  
Intraductal Papillary Mucinous Neoplasm ◽  
Labeling Index ◽  
Ki 67 ◽  
Mucinous Neoplasm ◽  
Mib 1

The immunohistochemical and radiological features of nonfunctioning pituitary adenomas

2015 ◽  
Vol 61 (6) ◽  
pp. 4-9 ◽  
Author(s):  
Anna Konstantinovna Lipatenkova ◽  
Larisa Konstantinovna Dzeranova ◽  
Ekaterina Aleksandrovna Pigarova ◽  
Nadezhda Sergeevna Dalantaeva ◽  
Ljudmila Igorevna Astaf'eva ◽  
...  
Keyword(s):  
Pituitary Adenomas ◽  
Area Under The Curve ◽  
Pituitary Hormones ◽  
Serum Markers ◽  
Invasive Growth ◽  
Null Cell ◽  
Ki 67 ◽  
Nonfunctioning Pituitary Adenomas ◽  
Radiological Features ◽  
Null Cell Adenomas

Pituitary adenomas without clinically active hypersecretion are summarized under the term nonfunctioning pituitary adenomas (NFPAs). Since there are no specific serum markers, the differential diagnosis and treatment imply special difficulties.Aim.To investigate the immunohistochemical and radiological features of NFPAs and assess the granins — chromogranin A (CgA), secretogranin II (SgII), secretoneurin (Sn) as immunohistochemical markers of NFPAs.Matherial and methods.50 pituitary adenomas excised surgically were immunostained to reveal pituitary hormones, ki-67, CgА. SgII, Sn. All patients underwent MRI, invasive growth was estimated due to J.Hardy classification (1973).Results.24 (51,1%) were gonadotropic tumors, 12 (25,5%) — null cell adenomas. Immunopositivity for ACTH was determined in 6 cases (12,7%), for GH in 5 (10,6%) cases, for PRL in 4 (8,5%). The median level of ki-67 was 2% (min. — 0.5%, max. — 7%). The CgA, SgII, Sn immunopositivity was found in 83, 93,6, 85,1% respectively, being more expressed in gonadotropinomas and null cell adenomas. Invasive growth was detected in 28 (44%) cases, among the invasive adenomas 22 tumors were giant. CgA expression is adverse prognostic factor, area under the curve (AUC) with 0,705. We did not find any correlation between ACTH-, STH-, CgII- and Sn- immunopositivity, ki-67 and invasive growth.Conclusions.Our work shows that a majority of NFPAs are truly secreting adenomas with significant numbers comprising potentially hazardous cortico- and somatotropinomas. CgA, SgII and Sn have a high expression in most of the NFPAs.

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