Comparison of Ki-67 index values between patients with operated giant prolactinomas and macroprolactinomas

Year 2022, , 17 - 22, 01.04.2022

Soner Cander , Özen Öz Gül

https://doi.org/10.46310/tjim.1070094

Abstract

Objective: Data on whether there is a histopathological difference in cellular features as determined with Ki-67 between giant prolactinomas and smaller macroprolactinomas are not fully clear. In this study, we aimed to compare Ki-67 value between patients followed-up with diagnosis of macroprolactinoma and giant prolactinoma and operated for different reasons.
Methods: Files of 15 patients with giant prolactinomas and 16 patients with macroprolactinomas who had been operated with various indications were retrospectively evaluated. Similar number of patients were included to carry out a reasonable analysis. Patients’ demographics (age and gender), age at the time of diagnosis, tumor diameter during the diagnosis and at the last follow-up visit, initial and last PRL and Ki-67 values were compared between the groups. Ki-67 value was studied with MIB-1 monoclonal antibody method.
Results: The mean age and gender were similar between the patients with macroprolactinomas and giant prolactinomas. The mean longest tumor diameter at diagnosis was measured as 18.13±9.42 mm in the macroprolactinoma and 47.07±9.70 mm in the giant prolactinoma group (p<0.001). The mean PRL level at diagnosis was found as 4534.93±12923.56 in the macroprolactinoma and 5513.08±7077.87 in the giant prolactinoma group (p=0.008). The mean Ki-67 value was found as 31.06±28.82 in the macroprolactinoma and 31.60±30.78 in the giant prolactinoma group. There was no significant difference between the groups in the Ki-67 values (p=0.922).
Conclusion: Ki-67 value was similar between macroprolactinomas and giant prolactinomas, suggesting that mitotic activity as determined by Ki-67 value is not practical in indicating growth and proliferation characteristics of prolactinomas.

Keywords

Macroprolactinoma, giant prolactinoma, pituitary adenoma, Ki-67, proliferation, biological behavior

References

• Cander S, Oz Gul O, Eylemer E, Gullulu Boz E, Gunes E, Hakyemez B, Yilmazlar S, Ersoy C. Comparison of the effects of medical and surgical treatments in giant prolactinoma: a single-center experience. Hormones (Athens). 2021;20(3):491- 8. doi: 10.1007/s42000-021-00307-0.
• Glezer A, Bronstein MD. Prolactinomas. Endocrinol Metab Clin North Am. 2015 Mar;44(1):71-8. doi: 10.1016/j.ecl.2014.11.003.
• Pekic S, Soldatovic I, Miljic D, Stojanovic M, Doknic M, Petakov M, Popovic V. Familial cancer clustering in patients with prolactinoma. Horm Cancer. 2019 Feb;10(1):45-50. doi: 10.1007/s12672-018-0348-3.
• Cooper O, Greenman Y. Dopamine agonists for pituitary adenomas. Front Endocrinol (Lausanne). 2018 Aug 21;9:469. doi: 10.3389/fendo.2018.00469.
• Espinosa E, Sosa E, Mendoza V, Ramírez C, Melgar V, Mercado M. Giant prolactinomas: are they really different from ordinary macroprolactinomas? Endocrine. 2016 Jun;52(3):652-9. doi: 10.1007/s12020-015-0791-7.
• Maiter D, Delgrange E. Therapy of endocrine disease: the challenges in managing giant prolactinomas. Eur J Endocrinol. 2014 Jun;170(6):R213-27. doi: 10.1530/EJE-14-0013.
• Moraes AB, Silva CM, Vieira Neto L, Gadelha MR. Giant prolactinomas: the therapeutic approach. Clin Endocrinol
• Yuhan L, Zhiqun W, Jihui T, Renlong P. Ki-67 labeling index and Knosp classification of pituitary adenomas. Br J Neurosurg. 2021 Apr 27:1-5. doi: 10.1080/02688697.2021.1884186.
• Cander S, Gül ÖÖ, Ertürk E, Tuncel E, Ersoy C. Prolactin levels and gender are associated with tumour behavior in prolactinomas but Ki-67 index is not. Endokrynol Pol. 2014;65(3):210-6. doi: 10.5603/EP.2014.0029.
• Bratthauer GL. The avidin-biotin complex (ABC) method and other avidin-biotin binding methods. Methods Mol Biol. 2010;588:257-70. doi: 10.1007/978-1-59745-324-0_26.
• Gillam MP, Molitch ME, Lombardi G, Colao A. Advances in the treatment of prolactinomas. Endocr Rev. 2006 Aug;27(5):485- 534. doi: 10.1210/er.2005-9998.
• Arzt E, Bronstein M, Guitelman M (eds): Pituitary Today II: New molecular, physiological and clinical aspects. Front Horm Res. Basel, Karger 2010; 38:50-8. doi: 10.1159/isbn.978-3-8055- 9445-5.
• Iglesias P, Díez JJ. Macroprolactinoma: a diagnostic and therapeutic update. QJM. 2013 Jun;106(6):495-504. doi: 10.1093/q jmed/hcs240.
• Kitchen T, Coles R, Smith A, Baglioni P, Okosieme OE. Giant prolactinoma in an elderly man. J Am Geriatr Soc. 2010 Jul;58(7):1402-4. doi: 10.1111/j.1532-5415.2010.02922.x.
• Almalki MH, Aljohani N, Alzahrani S, et al. Clinical features, therapeutic trends, and outcome of giant prolactinomas: A single-center experience over a 12-year period. Clin Med Insights Endocrinol Diabetes. 2020;13:1179551420926181. doi: 10.1177/1179551420926181.
• Paek KI, Kim SH, Song SH, Choi SW, Koh HS, Youm JY, Kim Y. Clinical significance of Ki-67 labeling index in pituitary macroadenoma. J Korean Med Sci. 2005 Jun;20(3):489-94. doi: 10.3346/jkms.2005.20.3.489.
• Parkins CS, Darling JL, Gill SS, Revesz T, Thomas DG. Cell proliferation in serial biopsies through human malignant brain tumours: measurement using Ki67 antibody labelling. Br J Neurosurg. 1991;5(3):289-98. doi: 10.3109/02688699109005189.
• Thotakura M, Tirumalasetti N, Krishna R. Role of Ki-67 labeling index as an adjunct to the histopathological diagnosis and grading of astrocytomas. J Cancer Res Ther. 2014 Jul- Sep;10(3):641-5. doi: 10.4103/0973-1482.139154.
• Pizarro CB, Oliveira MC, Coutinho LB, Ferreira NP. Measurement of Ki-67 antigen in 159 pituitary adenomas using the MIB-1 monoclonal antibody. Braz J Med Biol Res. 2004 Feb;37(2):235-43. doi: 10.1590/s0100-879x2004000200011.
• Bălinişteanu B, Cîmpean AM, Ceauşu AR, Corlan AS, Melnic E, Raica M. High Ki-67 expression is associated with prolactin secreting pituitary adenomas. Bosn J Basic Med Sci. 2017 May 20;17(2):104-8. doi: 10.17305/bjbms.2017.1750.