title: Correlation between clinical characteristics and proliferative activity in patients with craniopharyngioma.
abstract: OBJECTIVE
  The aim of the study was to correlate the Ki-67 and cyclin A labelling index (LI) with clinical characteristics and risk of recurrence of craniopharyngiomas.
  
  
  METHODS
  47 consecutive patients were studied, 21 female and 26 male, aged 34.3 (2.8) years. Immunohistochemical analysis was performed on paraffin wax embedded material using monoclonal antibodies directed against the proliferation associated nuclear antigen Ki-67 and cyclin A.
  
  
  RESULTS
  The median Ki-67 LI was 8.6% (interquartile range, 4.4%-14.0%). Ki-67 LI was significantly higher in tumours with a heavy inflammatory reaction and diabetes insipidus at presentation, whereas other clinical and histological features were not associated with the proliferation index. There was a strong linear correlation between Ki-67 LI and cyclin A LI (r = 0.77; p<0.0001); therefore, cyclin A LI showed the same clinical and histological relations described for Ki-67 LI. Recurrence of craniopharyngioma occurred in 13 of 46 patients (28.3%). The median Ki-67 LI in the 13 recurrent craniopharyngiomas (9.0%) was not significantly different from that of non-recurring tumours (7.9%). Cyclin A LI was also not associated with the risk of relapse.
  
  
  CONCLUSIONS
  This study confirms the great variability of proliferative activity in craniopharyngiomas. Ki-67 and cyclin A LIs were associated with the presence of a heavy inflammatory reaction and diabetes insipidus, but did not correlate with the long term risk of tumour regrowth.
authors.affiliation: Pituitary Unit, Department of Neurosurgery, Istituto Scientifico San Raffaele, University Vita-Salute, Milan, Italy. losa.marco@hsr.it
authors.forename: M
authors.initials: M
authors.lastname: Losa
authors.forename: A
authors.initials: A
authors.lastname: Vimercati
authors.forename: S
authors.initials: S
authors.lastname: Acerno
authors.forename: R L
authors.initials: RL
authors.lastname: Barzaghi
authors.forename: P
authors.initials: P
authors.lastname: Mortini
authors.forename: F
authors.initials: F
authors.lastname: Mangili
authors.forename: M R
authors.initials: MR
authors.lastname: Terreni
authors.forename: G
authors.initials: G
authors.lastname: Santambrogio
authors.forename: M
authors.initials: M
authors.lastname: Giovanelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor / Q000378:metabolism; D001932:Brain Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery*; D002453:Cell Cycle / Q000276:immunology / Q000502:physiology*; D002648:Child; D003397:Craniopharyngioma / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery*; D019925:Cyclin A / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000378:metabolism; D012307:Risk Factors
chemical_list: D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D019925:Cyclin A; D019394:Ki-67 Antigen