Результаты иммуногистохимических исследований в группах пациентов с макро- и гигантскими неактивными аденомами гипофиза после трансназальной селективной аденомэктомии

Юлдуз Урманова

doi:10.47689/2181-1415-vol6-iss11/S-pp1-9

Yulduz Urmanova Department of Internal Medicine, ALFRAGANUS UNIVERSITY

DOI

https://doi.org/10.47689/2181-1415-vol6-iss11/S-pp1-9

Keywords

NFPA , IHC , proliferation markers

Abstract

Aim. To perform a comparative analysis of immunohistochemical data in patients with macro- and giant non-functional pituitary adenomas (NFPA).

Materials and methods. Twenty patients with NFPA were studied: group 1 included 10 pituitary macroadenomas and group 2 included 10 giant pituitary adenomas. All patients underwent transnasal pituitary adenomectomy and a standardized diagnostic protocol that included fundus examination, visual-field testing every 3 months, and laboratory assays (STH, IGF-1, LH, FSH, ACTH, TSH, prolactin, free thyroxine, cortisol). Resected specimens were examined immunohistochemically with determination of Ki-67 and p53 expression.

Results. The odds of an aggressive NFPA phenotype were 8.2 times higher (p < 0.001) when invasive growth was present (sensitivity 86%, specificity 53%, Youden index 0.45, accuracy 66%). Per-percentage-point increases in marker expression were strongly associated with aggressiveness: a coefficient of 5.2 per percentage point for the Ki-67–positive tumor-cell nuclei (p < 0.001) and 3.1 per percentage point for p53-immunopositive nuclei (p < 0.001).

Conclusions. Significant threshold values were identified: p53 ≥ 2% (reported CI: 0.94) and a Ki-67 labelling index ≥ 4% (reported CI: 0.98), the latter being the most reliable individual marker for differentiating macro NFPA from giant NFPA. Tumors with immunoexpression of at least two markers were observed in 54% of the cohort and were classified as aggressive adenomas. By marker counts: p53-positive cases—4 in group 1 and 5 in group 2; Ki-67 ≥ 4%—5 in group 1 and 6 in group 2. Overall, 11 of 20 IHC-examined patients were assessed as having a risk of growth recurrence.

Downloads

Download data is not yet available.

References

Reddy R, Cudlip S, Byrne JV, Karavitaki N, Wass JA. Can we ever stop imaging in surgically treated and radiotherapy-naive patients with non-functioning pituitary adenoma? // Eur J Endocrinol. 2011 Nov;165(5):739-44. doi: 10.1530/EJE-11-0566.

Wass JA, Reddy R, Karavitaki N. The postoperative monitoring of nonfunctioning pituitary adenomas. // Nat Rev Endocrinol. 2011 Apr 5;7(7):431-4. doi: 10.1038/nrendo.2011.54

Raverot G, Dantony E, Beauvy J, Vasiljevic A, Mikolasek S, Borson-Chazot F, Jouanneau E, Roy P, Trouillas J. Risk of Recurrence in Pituitary Neuroendocrine Tumors: A Prospective Study Using a Five-Tiered Classification. // J Clin Endocrinol Metab. 2017 Sep 1;102(9):3368-3374. doi: 10.1210/jc.2017-00773.

Lee MH, Lee JH, Seol HJ, Lee JI, Kim JH, Kong DS, Nam DH. Clinical Concerns about Recurrence of Non-Functioning Pituitary Adenoma. // Brain Tumor Res Treat. 2016 Apr;4(1):1-7. doi: 10.14791/btrt.2016.4.1.1.

Murad MH, Fernández-Balsells MM, Barwise A, Gallegos-Orozco JF, Paul A, Lane MA, Lampropulos JF, Natividad I, Perestelo-Pérez L, Ponce de León-Lovatón PG, Albuquerque FN, Carey J, Erwin PJ, Montori VM. Outcomes of surgical treatment for nonfunctioning pituitary adenomas: a systematic review and meta-analysis. //Clin Endocrinol (Oxf). 2010 Dec;73(6):777-91. doi: 10.1111/j.1365-2265.2010.03875.x.

Холова Д.Ш., Халимова З.Ю., Урманова Ю.М., Алиева Д.А., Алимухамедова Г.О.«Состояние показателей, характеризующих состояние процессов апоптоза и ангиогенеза у больных с неотягощенным семейным анамнезом неактивных аденом гипофиза (НАГ)».// Международный Эндокринологический, Украина, №6, 70, 2015г, стр 28-31

Zakir JC, Casulari LA, Rosa JW, Rosa JW, de Mello PA, de Magalhães AV, Naves LA. Prognostic Value of Invasion, Markers of Proliferation, and Classification of Giant Pituitary Tumors, in a Georeferred Cohort in Brazil of 50 Patients, with a Long-Term Postoperative Follow-Up. // Int J Endocrinol. 2016;2016:7964523. doi: 10.1155/2016/7964523.

Zierhut D, Flentje M, Adolph J, Erdmann J, Raue F, Wannenmacher M. External radiotherapy of pituitary adenomas. // Int J Radiat Oncol Biol Phys. 1995 Sep 30;33(2):307-14. doi: 10.1016/0360-3016(95)00071-6.

Downloads

PDF (Русский)

11 4

Published

2025-11-25

Results of immunohistochemical studies in groups of patients with macro- and giant non-functioning pituitary adenomas after transnasal selective adenomectomy

How to Cite

Urmanova, Y. (2025). Results of immunohistochemical studies in groups of patients with macro- and giant non-functioning pituitary adenomas after transnasal selective adenomectomy. Society and Innovation, 6(11/S), 1–9. https://doi.org/10.47689/2181-1415-vol6-iss11/S-pp1-9