title: Radically resected pituitary adenomas: prognostic role of Ki 67 labeling index in a monocentric retrospective series and literature review.
abstract: Ki-67 Labeling Index is an immunocytochemical marker of cell proliferation. The correlation of Ki-67 expression with pituitary adenomas recurrence has been investigated and is highly debated. Aim of this study was to evaluate whether Ki-67 correlates with recurrence even in patients with an apparently completely removed pituitary adenoma. We retrospectively reviewed the database of the Hypothalamic-Pituitary Disease Unit at the Catholic University of Rome, collected between 2003 and 2011. Inclusion criteria were: patients who underwent surgery at the Department of Neurosurgery with an apparently complete removal of a pituitary adenoma; Ki-67 histological evaluation by the same operator and values of <3%. All patients underwent endocrine evaluation of the hypothalamic-pituitary function, ophthalmologic and neuro-radiological examinations, during the preoperative period and follow-up. Out of 490 patients recorded on the database of the Hypothalamic-Pituitary Disease Unit at the Catholic University of Rome, 191 cases met the inclusion criteria. Recurrence was observed in 49 cases (25.7% of the patients who had undergone radical excision). Optional cut-off value was identified at Ki-67 values of 1.50%. This was associated with worse disease-free survival time, even after correction for age at treatment, gender, positivity to p53, functional classification and Knosp grading. Ki-67 labeling index may be useful in postoperative management, even in patients who underwent radical PA removal. We suggest a Ki-67 cut-off value of 1.5% to plan an adequate clinical follow-up.
authors.affiliation: Section of Endocrinology, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Policlinico Gemelli, Largo A. Gemelli, 8, 00168, Rome, Italy, schiloiro@gmail.com.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Chiloiro
authors.forename: Antonio
authors.initials: A
authors.lastname: Bianchi
authors.forename: Francesco
authors.initials: F
authors.lastname: Doglietto
authors.forename: Chiara
authors.initials: C
authors.lastname: de Waure
authors.forename: Antonella
authors.initials: A
authors.lastname: Giampietro
authors.forename: Alessandra
authors.initials: A
authors.lastname: Fusco
authors.forename: Donato
authors.initials: D
authors.lastname: Iacovazzo
authors.forename: Linda
authors.initials: L
authors.lastname: Tartaglione
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Nardo
authors.forename: Francesco
authors.initials: F
authors.lastname: Signorelli
authors.forename: Libero
authors.initials: L
authors.lastname: Lauriola
authors.forename: Carmelo
authors.initials: C
authors.lastname: Anile
authors.forename: Guido
authors.initials: G
authors.lastname: Rindi
authors.forename: Giulio
authors.initials: G
authors.lastname: Maira
authors.forename: Alfredo
authors.initials: A
authors.lastname: Pontecorvi
authors.forename: Laura
authors.initials: L
authors.lastname: De Marinis
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D010901:Pituitary Function Tests; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D019394:Ki-67 Antigen