Preoperative Risk Stratification of Increased MIB-1 Labeling Index in Pituitary Adenoma: A Newly Proposed Prognostic Scoring System
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Inclusion Criteria
2.2. Data Recording
2.3. Neuropathology
2.4. Follow-Up Scheduling
2.5. Statistical Analysis
3. Results
3.1. Probability of Progression-Free Survival in Pituitary Adenoma and Prognostic Value of MIB-1 Labeling Index in the Prediction of Recurrent Pituitary Adenoma
3.2. Patient Characteristics of the Screening group for Baseline Characteristics Being Associated with Elevated MIB-1 Labeling Index
3.3. Pituitary Adenoma Growth Pattern, Surgical Therapy, and Neuropathological Pituitary Adenoma Types
3.4. Screening for Associations between MIB-1 Labeling Index and Patient Characteristics
3.5. Scoring System
3.6. FATE Score and Progression-free Survival
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Median Age (IQR) (In y) | 60 (47–70) |
---|---|
Sex Female Male | 49 (45.0%) 60 (55.0%) |
Median preoperative KPS (IQR) | 90 (90–100) |
Maximum diameter (mm) | 21 (14–27) |
Cavernous sinus invasion | 43 (39.4%) |
Pituitary apoplexy | 6 (5.5%) |
Extent of resection Gross total resection Subtotal resection | 67 (61.5%) 42 (38.5%) |
Pathological tumor types Gonadotroph adenoma Plurihormonal adenoma Null cell adenoma Corticotroph adenoma Somatotroph adenoma Prolactinoma Thyrotroph adenoma | 49 (45%) 35 (32.1%) 11 (10.1%) 8 (7.3%) 3 (2.8%) 2 (1.8%) 1 (0.9%) |
Median MIB-1 labeling index (%), IQR | 3 (2–4) |
p53 expression (available in 88 patients) | 44 (50.0%) |
Variable | MIB-1 < 4% (n = 77) | MIB-1 ≥ 4% (n = 32) | p-Value |
---|---|---|---|
Sex Female Male | 38 (49.4%) 39 (50.6%) | 11 (34.3%) 21 (65.5%) | 0.21 |
Age, mean ± SD | 61.4 ± 15.6 | 49.3 ± 15.9 | <0.001 |
Preoperative KPS, mean ± SD | 90.9 ± 10.8 | 92.2 ± 8.7 | 0.55 |
Body mass index, mean ± SD | 28.7 ± 5.8 | 30.8 ± 9.1 | 0.16 |
Acromegaly Present Not present | 12 65 | 6 26 | 0.78 |
Cushing´s disease Present Not present | 2 75 | 2 30 | 0.58 |
Diabetes Present Not present | 8 (10.4%) 69 (89.6%) | 6 (18.8%) 26 (81.2%) | 0.35 |
Acetylsalicylic acid intake Present Not present | 8 10.4%) 69 (89.6%) | 3 (18.8%) 29 (81.2%) | 0.99 |
Pituitary apoplexy Present Not present | 4 (5.2%) 73 (94.8%) | 2 (6.3%) 30 (93.7%) | 0.99 |
Maximum diameter (mm), mean ± SD | 21.8 ± 9.8 | 21.3 ± 9.0 | 0.81 |
Microadenoma Macroadenoma | 13 (16.9%) 64 (83.1%) | 6 (18.7%) 26 (81.3%) | 0.79 |
Plurihormonal (immunohistochemical) Present Not present | 24 (31.2%) 53 (61.8%) | 11 (34.4%) 21 (65.6%) | 0.82 |
Cavernous sinus invasion Present Not present | 28 (36.4%) 49 (63.6%) | 15 (46.9%) 17 (53.1%) | 0.39 |
Preoperative hormone replacement Hydrocortisone Levothyroxine Testosterone Levothyroxine and testosterone Hydrocortisone and levothyroxine Hydrocortisone and testosterone and levothyroxine None | 12 (15.6%) 11 (14.3%) 0 (0.0%) 1 (1.3%) 10 (13.0%) 1 (1.3%) 42 (54.5%) | 11 (34.4%) 5 (15.6%) 1 (3.1%) 0 (0.0%) 4 (12.5%) 0 (0.0%) 11 (34.4%) | 0.14 |
p53 expression (available in 88 patients) present not present | 27 (46.55%) 31 (53.45%) | 17 (56.66%) 13 (43.33%) | 0.50 |
Baseline Plasma fibrinogen (g/L), mean ± SD | 3.19 ± 0.89 | 3.55 ± 0.89 | 0.06 |
Baseline Serum C-reactive protein (mg/I), mean ± SD | 4.76 ± 14.81 | 6.22 ± 11.55 | 0.62 |
Baseline TSH (µU/mL), mean ± SD | 1.30 ± 0.83 | 1.44 ± 0.81 | 0.45 |
Baseline IGF-1 (ng/mL), mean ± SD | 189.56 ± 238.51 | 293.46 ± 310.77 | 0.06 |
Baseline ACTH (pg/mL), mean ± SD | 26.76 ± 20.34 | 39.54 ± 34.36 | 0.03 |
Baseline LH (U/I), mean ± SD | 5.15 ± 6.40 | 3.56 ± 4.68 | 0.22 |
Baseline FSH (mIU/mL), mean ± SD | 13.53 ± 18.47 | 8.07 ± 12.63 | 0.09 |
Baseline prolactin (ng/mL), mean ± SD | 29.18 ± 33.00 | 28.48 ± 39.73 | 0.93 |
Baseline estradiol (pg/mL), mean ± SD | 21.38 ± 25.77 | 47.84 ± 93.66 | 0.38 |
Baseline testosterone (ng/mL), mean ± SD | 1.98 ± 1.85 | 1.53 ± 1.11 | 0.20 |
Baseline growth hormone (ng/mL), mean ± SD | 5.15 ± 12.64 | 6.50 ± 12.24 | 0.69 |
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Maiseyeu, I.; Güresir, Á.; Vatter, H.; Herrlinger, U.; Becker, A.; Wach, J.; Güresir, E. Preoperative Risk Stratification of Increased MIB-1 Labeling Index in Pituitary Adenoma: A Newly Proposed Prognostic Scoring System. J. Clin. Med. 2022, 11, 7151. https://doi.org/10.3390/jcm11237151
Maiseyeu I, Güresir Á, Vatter H, Herrlinger U, Becker A, Wach J, Güresir E. Preoperative Risk Stratification of Increased MIB-1 Labeling Index in Pituitary Adenoma: A Newly Proposed Prognostic Scoring System. Journal of Clinical Medicine. 2022; 11(23):7151. https://doi.org/10.3390/jcm11237151
Chicago/Turabian StyleMaiseyeu, Ivan, Ági Güresir, Hartmut Vatter, Ulrich Herrlinger, Albert Becker, Johannes Wach, and Erdem Güresir. 2022. "Preoperative Risk Stratification of Increased MIB-1 Labeling Index in Pituitary Adenoma: A Newly Proposed Prognostic Scoring System" Journal of Clinical Medicine 11, no. 23: 7151. https://doi.org/10.3390/jcm11237151