title: The impact of immunohistochemical markers of Ki-67 and p53 on the long-term outcome of growth hormone-secreting pituitary adenomas: A cohort study.
abstract: OBJECTIVE
  The tumoral biomarkers have a rather well known effect upon the tumor control period of several types of malignant lesions. The aim of this study was to evaluate the impact of immunohistochemical (IHC) markers of Ki-67 and p53 on the long-term outcome of growth hormone (GH)-secreting pituitary adenomas treated surgically.
  
  
  METHODS
  We conducted and followed a cohort of 47 consecutive patients with GH-secreting pituitary adenomas referred to our department during a 4 year period for trans-sphenoidal microsurgical adenomectomy. The expression levels of Ki-67 and p53 were determined by IHC study of the tissue samples. Periodical pituitary magnetic resonance imaging (MRI), visual field studies and hormonal evaluations (GH and insulin-like growth factor-1 [IGF-1]) performed during the follow-up period were the outcome measures.
  
  
  RESULTS
  The level of Ki-67 expression was higher among patients with postoperative residual tumor (3.5 vs. 1.7%) and those with a hormonal recurrence (4.3 vs. 1.6%). The p53 expression level was remarkably higher in patients with radiological recurrence (18 vs. 6.3%). Patients with invasive features (i.e. cavernous sinus and suprasellar invasion) had significantly higher p53 and Ki-67 values and higher IGF-1 levels during the follow-up period. The patients younger than 30 years of age and those with mixed GH-prolactin secreting adenomas had significantly higher hormonal remission and lower radiological recurrence rates.
  
  
  CONCLUSIONS
  Each of the biomarkers, Ki-67 and p53, along with patient's age and mixed GH-prolactin secretion showed a kind of correlation with each of aspects of the clinical, hormonal and radiologic outcome of GH-secreting pituitary adenomas in this series.
authors: Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
authors: Maysam
authors: M
authors: Alimohamadi
authors: Department of Neurosurgery, Sina Hospital Tehran University of Medical Sciences, Tehran, Iran.
authors: Vahid
authors: V
authors: Ownagh
authors: Department of Endocrinology, Arad Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Leila
authors: L
authors: Mahouzi
authors: The Persian Gulf Infectious Diseases and Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran.
authors: Afshin
authors: A
authors: Ostovar
authors: Department of Neurosurgery, Arad Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Kazem
authors: K
authors: Abbassioun
authors: Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Abbas
authors: A
authors: Amirjmshidi
keywords: Acromegaly; Ki-67; growth hormone; immunohistochemistry; p53; pituitary adenoma