DNA-flow cytometry of 207 pituitary adenomas: ploidy, proliferation, and prognosis.
The principal factors involved in pituitary adenoma formation are unknown. DNA-flow cytometry is a useful study providing an estimation of a tumor proliferative rate. In this study, DNA-flow cytometry was performed to evaluate its capability to both assess prognosis and predict recurrence. Two hundred and seven fresh pituitary adenoma specimens were assessed by flow cytometry. Pre-operative endocrine function, previous medical treatment, radiographic appearance, surgical findings and immunohistochemistry were recorded for each patient. Patient outcomes were assessed at a mean follow-up of 5.3 +/- 3.1 yr. Endocrinologically inactive pituitary adenomas were predominantly euploids (50.8%). The highest proliferation rates occurred in Nelson's syndrome and the lowest in Cushing's disease. A significant difference in proliferation was observed with prolactinomas and acromegaly when a medical treatment was performed before primary surgery. Massive histological invasiveness was directly associated with a significant increase in proliferation rate. Radiotherapy did not affect the recurrence rate (4.4%) statistically. In conclusion, DNA-flow cytometry was found to be useful for determining ploidy and obtaining an overview of cell cycle status. It was helpful in identifying patients requiring closer follow-up, such as those with invasive adenomas and Nelson's syndrome. No single parameter revealed by DNA-flow cytometry could predict tumor prognosis or recurrence in the follow-up of 7.5 +/- 1.3 yr.
Machado
A L O
AL
Department of Neurosurgery, University of Erlangen-Nuernberg, Germany. analuiza_machado@hotmail.com
Nomikos
P
P
Kiesewetter
F
F
Fahlbusch
R
R
Buchfelder
M
M
D000236:Adenoma / Q000235:genetics / Q000473:pathology* / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D024221:Antineoplastic Protocols; D049109:Cell Proliferation; D004273:DNA, Neoplasm / Q000032:analysis* / Q000235:genetics; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010911:Pituitary Neoplasms / Q000235:genetics / Q000473:pathology* / Q000628:therapy*; D011003:Ploidies; D011237:Predictive Value of Tests
D004273:DNA, Neoplasm