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p53 and MIB-1 Immunohistochemistry as Predictors of the Clinical Behavior of Nonfunctioning Pituitary Adenomas

  • Stephen J. Hentschel (a1) (a2), Ian E. McCutcheon (a2), Wayne Moore (a3) and Felix A. Durity (a1)

Abstract:

Background:

P53 expression and increased MIB-1 proliferation index have been shown to correlate with invasive behavior in pituitary adenomas. The purpose of this study was to determine whether these indices could be used to predict a higher likelihood of recurrence in clinically nonfunctional pituitary adenomas and thus guide adjuvant therapy.

Methods:

Fifty-one clinically nonfunctional pituitary adenomas were selected from the database at the Vancouver Hospital and Health Sciences Center between the years 1990-1998. Included were 32 nonrecurrent and 19 recurrent adenomas.

Results:

The mean initial labelling index for p53 in nonrecurrent tumours was 0.38% (0-1.58%), while it was 0.46% (0-3.65%) for recurrent adenomas. The mean initial MIB-1 index for nonrecurrent tumours was 1.63% (0.08-9.36%), while for recurrent tumours it was 1.92% (0-7.76%). The percentage of p53 positive adenomas was 66% for nonrecurrent tumours and 68% for recurrent tumours. None of the differences in the labelling indices between the recurrent and nonrecurrent groups was statistically significant. As 12 patients (38%) in the nonrecurrent group had undergone radiotherapy as initial adjuvant therapy after surgery and none of the recurrent group had done so, patients who did not receive radiotherapy in the nonrecurrent group were analyzed separately. Again, none of the differences in the labelling indices between the recurrent and nonrecurrent groups was statistically significant when the effect of radiotherapy was removed from the analysis.

Conclusions:

The results demonstrate no statistical difference in the p53 or MIB-1 labelling indices between recurrent and nonrecurrent nonfunctional pituitary adenomas. Concern should be raised in attaching too much clinical significance to these labelling indices, especially with respect to p53 as a predictor of the clinical behavior of nonfunctional pituitary adenomas.

RÉSUMÉ: Introduction:

Dans les adénomes hypophysaires, il existe une corrélation entre un comportement envahissant de la tumeur et l’expression de la p53 et une augmentation de l’index de prolifération MIB-1. Le but de cette étude était de déterminer si ces indices pouvaient être utilisés pour prédire le risque de récidive des adénomes hypophysaires cliniquement non fonctionnels et ainsi guider le traitement adjuvant.

Méthodes:

Cinquante et un adénomes hypophysaires cliniquement non fonctionnels, dont 32 étaient non récurrents et 19 récurrents, ont été sélectionnés dans la base de données du Vancouver Hospital et du Health Sciences Center entre 1990 et 1998.

Résultats:

L’index de marquage initial moyen pour la p53 était de 0,38% pour les tumeurs non récurrentes (0-1,58%) et de 0,46% (0-3,65%) pour les adénomes récurrents. L’index MIB-1 initial moyen pour les tumeurs non récurrentes était de 1,63% (0,08-9,36%) et de 1,92% (0-7,76%) pour les tumeurs récurrentes. Soixante-six pour cent des adénomes non récurrents et 68% des adénomes récurrents étaient positifs pour la p53. Aucune des différences entre les indices de marquage entre les deux groupes n’atteignait le seuil de significativité. Étant donné que 12 patients (38%) du groupe ayant un adénome non récurrent avaient subi de la radiothérapie comme traitement adjuvant initial après la chirurgie et qu’aucun n’en avait reçu dans le groupe ayant un adénome récurrent, les données des patients qui n’ont par reçu de radiothérapie dans le groupe ayant un adénome non récurrent ont été analysées séparément. Aucune des différences entre les deux groupes dans les indices de marquage n’atteignait le seuil de significativité quand l’effet de la radiothérapie était retiré de l’analyse.

Conclusions:

Ces résultats ne démontrent aucune différence statistique dans les indices de marquage par l’anticorps de la p53 et de MIB-1 entre les adénomes hypophysaires non fonctionnels récurrents et non récurrents. On doit se garder d’attribuer une trop grande signification clinique à ces indices de marquage, surtout quant à la p53, pour prédire l’évolution clinique des adénomes hypophysaires non fonctionnels.

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References

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p53 and MIB-1 Immunohistochemistry as Predictors of the Clinical Behavior of Nonfunctioning Pituitary Adenomas

  • Stephen J. Hentschel (a1) (a2), Ian E. McCutcheon (a2), Wayne Moore (a3) and Felix A. Durity (a1)

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