Charakter wzrostu gruczolaków przysadki typu prolactinoma zależy od stężenia prolaktyny i płci pacjentów, ale nie od wartości wskaźnika Ki-67

Abstract

Introduction: The objective of this study was to investigate the effects of some clinical and pathological features of prolactinomas on tumour behaviour. Material and methods:The study included 113 patients with prolactinoma (27 male, 86 female), with a mean age at diagnosis of 34.4 ± ± 10.0 years (40.3 ± 12.6 in males, 32.6 ± 8.3 in females). Patients were grouped as invasive or non-invasive according to radiological imaging findings. Ki-67 levels were evaluated if possible. Results: The mean adenoma size (longest dimension) was 38.6 ± 21.6 mm and 10.8 ± 9.4 mm in male and female patients. Pre-treatment serum levels of prolactin were defined as mean 1,926 ± 6,662ng/mL in all, 124.8 ± 63.4 and 4,675 ± 10,049ng/mL in the noninvasive and invasive groups (p < 0.05). A positive correlation was found between the serum levels of prolactin and tumour size. The rate of patients with Ki-67 ≥ 0.03 was 37.5% and 47.8% in the noninvasive and invasive groups. The reduction rates were 60.8% and 80.4% in tumour sizes and 81.1% and 93.8% in prolactin level in the noninvasive and invasive groups, respectively, (p < 0.05). Conclusions:We found a strong correlation between prolactin levels and invasiveness in male patients compared to females. Ki-67 index was not found to have a place in defining the prognosis.

Prolactinomas: Prognostic Factors of Early Remission After Transsphenoidal Surgery

“…Similar to other investigators, we showed that preoperative serum prolactin concentrations correlated positively with prolactinoma size (15,31), tumor invasiveness (15,32), and patient age (33). The positive relationship between age and prolactin concentrations may be explained by larger tumors observed in older patients than in younger individuals (33).…”

“…In another study, invasive and noninvasive prolactinomas, as assessed radiologically, also had similar Ki-67 indices (15). Thus, radiological and microscopic markers of prolactinoma invasiveness seem unrelated.…”

“…Previous studies suggested that men, elderly patients, patients with large, invasive, or highly proliferating tumors, and patients with high post-operative prolactin concentrations or previous incomplete resections are less likely to achieve remission after surgical removal of prolactinomas (14)(15)(16)(17)(18)(19). However, predicting outcomes of prolactinoma resection based on the available evidence remains difficult (20).…”

Pituitary Adenomas and Invasiveness from Anatomo-Surgical, Radiological, and Histological Perspectives: A Systematic Literature Review

“…Obviously, correct assessment of tumor invasion is mandatory for this approach, as is evaluation of proliferation. Indeed, in our review of the literature we found a robust association between proliferation, assayed by Ki-67, and presence of invasiveness with 62% of revised reports suggesting a positive correlation [145][146][147] and 38% indicating an unclear association, albeit with a positive trend [13,148,149]. The controversial data on p53 and Ki-67 expression and correlation with invasiveness might in part be a result of differences in defining invasion, as reported by Sarkar et al [140] and discussed herein.…”

“…The reported frequency of invasive PAs varies considerably, from 2-3% [8] to 21% [9,10]. Predilected sex remains matter of debate, although they seem to be larger and more frequent in men [11][12][13][14]; conflicting results are reported for age incidence [15], including those in childhood and adolescence [16][17][18][19][20].…”