Proliferative activity and invasiveness among pituitary adenomas and carcinomas: An analysis using the MIB-1 antibody

被引:348
作者
Thapar, K
Kovacs, K
Scheithauer, BW
Stefaneanu, L
Horvath, E
Pernicone, PJ
Murray, D
Laws, ER
机构
[1] ST MICHAELS HOSP,DEPT PATHOL,TORONTO,ON M5B 1W8,CANADA
[2] UNIV TORONTO,TORONTO,ON,CANADA
[3] MAYO CLIN & MAYO FDN,DEPT SURG PATHOL,ROCHESTER,MN 55905
[4] FLORIDA HOSP MED CTR,DEPT PATHOL,ORLANDO,FL 32803
[5] UNIV VIRGINIA,DEPT NEUROL SURG,CHARLOTTESVILLE,VA
关键词
invasiveness; Ki-67; pituitary adenomas; pituitary carcinomas; proliferation markers;
D O I
10.1097/00006123-199601000-00024
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
ALTHOUGH HISTOLOGICALLY BENIGN, one-third of all pituitary tumors will be invasive of surrounding structures. In this study, the relationship between the proliferative activity in pituitary adenomas and their invasiveness was investigated. Invasion was defined as gross, operatively or radiologically apparent infiltration of dura or bone. Using the recently developed MIB-1 monoclonal antibody, which recognizes the Ki-67 cell cycle-specific nuclear antigen, the growth fractions of 37 noninvasive adenomas, 33 invasive adenomas, and 7 primary pituitary carcinomas were determined. All tumors were fully classified by histology, immunohistochemistry, and electron microscopy. The mean Ki-67-derived growth fractions for noninvasive adenomas,:invasive adenomas, and pituitary carcinomas were 1.37 +/- 0.15%, 4.66 +/- 0.57%, and 11.91 +/- 3.41%, respectively (mean +/- standard error of the mean). An analysis of variance and then individual pairwise comparisons confirmed significant differences in the mean Ki-67 labeling index between each of the three tumor groups (P < 0.01). The mean growth fraction of hormonally active pituitary adenomas (3.25 +/- 0.26%) was significantly higher than that for nonfunctioning adenomas (2.06 +/- 0.23%) (P = 0.03). Establishing a threshold labeling index of 3% served to distinguish invasive from noninvasive adenomas with 97% specificity and 73% sensitivity and was associated with positive and negative predictive values of 96 and 80%, respectively. Although invasive pituitary tumors exhibited significantly higher growth fractions than did noninvasive tumors, there were individual exceptions, indicating that in a subpopulation of invasive pituitary tumors, factors other than proliferative activity determine invasive potential.
引用
收藏
页码:99 / 106
页数:8
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