Prognostic Factors for Invasiveness and Recurrence of Pituitary Adenomas: A Series of 94 Patients

Abstract

(1) Background: The aim of the current study is to evaluate the immunohistochemical expression of Ki-67, CD-56, Cyclin-D1 and E-Cadherin in the tissues samples of pituitary adenomas (PAs) and its association with PAs clinical manifestation tumor size, invasiveness and the risk of recurrence. (2) Materials and Methods: Ninety-four patients who underwent endoscope transsphenoidal excision of PAs were included in our study. The immunohistochemical expression of the Cyclin-D1, CD-56, E-Cadherin and Ki-67 markers was analyzed in paraffin-embedded tissue samples. (3) Results: The expression of Cyclin-D1 and Ki-67 index levels was positively correlated with the size (p < 0.001, r = 0.56 and p < 0.001, r = 0.43, respectively), the recurrence (p < 0.001, r = 0.46 and p = 0.007 r = 0.3, respectively), the extrasellar extension (p < 0.001, r = 0.48 and p < 0.001, r = 0.4, respectively) and the cavernous sinus invasion of (p < 0.001, r = 0.39 and p < 0.001, r = 0.3, respectively). No correlation was found between CD-56 and E-Cadherin expression with the size, the invasiveness and the recurrence of PAs. (4) Conclusion: Cyclin-D1 and Ki-67 are promising immunohistochemical markers in predicting the invasive behavior and recurrence of PAs in contrast to E-Cadherin and CD-56 which did not seem to be associated with PAs behavior post-surgery. However, larger studies are required in order to establish their role in the routine evaluation of PAs.

Pathologic Characteristics of Somatotroph Pituitary Tumors—An Observational Single-Center Study

“…Hasanov et al showed that pituitary tumors with Ki-67 ≥ 3% presented more frequently as macroadenomas with cavernous sinus invasion, with higher surgery numbers and recurrence rates when compared to tumors with Ki-67 < 3% [27]. Stefanidis et al confirmed positive correlation between the Ki-67 index and tumor size, extrasellar extension, cavernous sinus invasion, as well as recurrence rate [28]. Meanwhile, Sadeghipour et al reported that the Ki-67 index was correlated with tumor invasiveness, but not with recurrence rate [29].…”

“…Regarding the proliferation index Ki-67, its meaning has already been widely analyzed in pituitary tumors. It has been shown that higher Ki-67 index values were correlated with the local invasiveness and clinical aggressiveness of the tumor [27][28][29]. Hasanov et al showed that pituitary tumors with Ki-67 ≥ 3% presented more frequently as macroadenomas with cavernous sinus invasion, with higher surgery numbers and recurrence rates when compared to tumors with Ki-67 < 3% [27].…”