ECE2018 Poster Presentations: Pituitary and Neuroendocrinology Pituitary - Clinical (101 abstracts)
Predictors of clinical behavior of pituitary adenomas
Mirsala Solak 1 , Tina Dušek 1 , Ivana Kraljević 1 , Tanja Škorić Polovina 1 , Annemarie Balaško 1 , Ante Melada 2 , Vjerislav Peterković 2 , Marcel Marjanović Kavanagh 3 , Antonia Jakovčević 4 , David Ozretić 5 & Darko Kaštelan 1
1Division of Endocrinology, Center of Neuroendocrinology Zagreb, Zagreb, Croatia; 2Department of Neurosurgery, Center of Neuroendocrinology Zagreb, Zagreb, Croatia; 3Department of Otorhinolaryngology, Zagreb, Croatia; 4Department of Pathology, UHC Zagreb, Zagreb, Croatia; 5Department of Radiology, UHC Zagreb, Zagreb, Croatia.
The aim of this study was to investigate the expression of histological markers Ki-67, p53 and mitotic activity in pituitary adenomas and their correlation with the frequency of recurrence and progression of residual adenoma. The study comprised 94 patients treated at the Department of Endocrinology, University Hospital Center Zagreb in the period from 2005 to 2011. After the operation, 63.8% of patients had residual adenoma. In the minority of patients (12/60 patients, 20%) with residual adenoma we detected increase in size. In patients with complete adenoma resection, only few patienst had recurrence (3/34 patients, 8.8%). The size of the denoma had a significant prognostic value for residual tumor (P=0.027). In majority of adenoma samples (74.5%) expression of Ki-67 was less than 3%, 26.1% had positive p53 while only 9.6% had mitotic activity. Functional adenomas had significantly higher expression of Ki-67 compared to nonfunctional adenomas (P=0.012). The expression of the Ki-67 in the pituitary adenoma correlated positively with the recurrence of adenoma as well as the increase in residual adenoma (P<0.001). Cut-off value of Ki-67 ≥3% was significant for the time of residual adenoma progression or adenoma recurrence after complete removal (P=0.007). All patients with residual adenoma, regardless of the clinical outcome, had a significantly higher expression of Ki-67 compared to patients without residue (P=0.009). Patients with residual adenomas had significantly larger and more invasive adenomas (P<0.001 and P=0.002, respectively). In patients with enlargement of residual adenoma or recurrence after complete removal, the expression of Ki-67 was higher compared to patients with stable residue or complete adenoma removal (P<0.001). Patients with increased residue size and recurrent adenomas had significantly larger initial size of the adenoma (P=0.045). Moreover, these patients had higher expression of Ki-67 compared only to the group of patients with stable residue (P=0.005). Based on this study we can conclude that patients with larger adenoma size and higher expression of proliferative marker Ki-67 have an increased chance of progression of residual adenoma or recurrence after complete removal.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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