Expression Of Ki-67 And Hormone Level In Pituitary Adenomas

Objective Objective to analyze the correlation between Ki-67 labeling index and preoperative serum endocrine hormone levels in pituitary adenomas and knosp grading,and to explore the diagnostic value of Ki-67 labeling index and preoperative hormone levels in evaluating the invasiveness of pituitary adenomasMethods Methods from July 2015 to August 2020,185 patients with pituitary adenomas were selected as the research objects.Demographic data,preoperative endocrine hormone values,preoperative pituitary magnetic resonance imaging(MRI),postoperative pathological immunohistochemical results and Ki-67 labeling index were collected.Spearman correlation analysis was used to determine the correlation between Ki-67 labeling index,preoperative hormone levels and knosp classification.P < 0.05 was the correlation.Knosp grades 0,I and II were defined as non-invasive pituitary adenomas,and grades III and IV as invasive pituitary adenomas.The preoperative hormone threshold and Ki-67 labeling index threshold of invasive pituitary adenomas were determined by ROC curve.Results 1.In this study,according to the results of pathological immunohistochemical staining,multi hormone adenoma was the most,followed by zero cell adenoma,ACTH adenoma,PRL adenoma,GH adenoma,FSH adenoma,and TSH adenoma.2.the incidence rate of pituitary adenomas is 20～40 years old.There is no obvious discrepancy in the incidence between male and female in general.In FSH adenoma group,there are more males than females.There are more females in ACTH adenoma group than men.3.The most common clinical manifestations of pituitary adenoma were dizziness,headache,decreased vision and visual field defect,followed by menopause,lactation,sexual dysfunction and other endocrine disorders.4.In pituitary adenomas,there was no significant difference in Ki-67 labeling index among different types.5.The Ki-67 labeling index of pituitary adenomas was positively correlated with the knsop grade.Ki-67 labeling index ≥ 2.5% can be used as an index to judge the invasiveness of pituitary adenomas.6.The Ki-67 labeling index of IPA was obviously beyond that of NIPA;there was no obvious discrepancy in Ki-67 labeling index about gender;there was no obvious correlation between Ki-67 labeling index and tumor maximum diameter.7.PRL hormone value is the highest in PRL type adenoma,GH hormone value is the highest in GH type adenoma,clinical classification and pathological classification are consistent;8.The preoperative PRL level of PRL type adenoma,multi hormone adenoma and all adenoma patients is positively correlated with knosp grade,while the preoperative ACTH,GH,TSH,FSH and LH levels of patients are not correlated with knosp grade;the preoperative PRL hormone value of PRL type pituitary adenoma ≥ 46 ng / ml can be used as a reference Objective to evaluate the invasiveness of pituitary adenomas.9.There was no obvious discrepancy in ACTH,GH,TSH,FSH and LH between IPA and NIPA,but the preoperative PRL in IPA was obviously beyond that in NIPA.10.In PRL adenoma and multi hormone adenoma,the preoperative PRL hormone level was significantly positively correlated with Ki-67 marker index,while in other types and hormones,the preoperative hormone level was not correlated with Ki-67 marker index.Conclusion In this study,we selected two commonly used indicators of pituitary adenomas: preoperative hormone level and Ki-67 labeling index in pathological immunohistochemistry.Through knosp grading,a commonly used criterion for judging the invasiveness of pituitary adenomas,we found that Ki-67 labeling index and preoperative PRL hormone level were positively correlated with knosp grading,that is,Ki-67 labeling index and preoperative PRL hormone level were correlated with the invasiveness of pituitary adenomas,The Ki-67 labeling index and preoperative PRL hormone levels of IPA were obviously beyond those of NIPA,which provided two more objective criteria for clinical judgment of invasive pituitary adenomas and had a certain guiding value for clinical practice.In this study,we concluded that the possibility of invasion should be considered for patients with Ki-67 labeling index ≥ 2.5% or PRL type adenomas with preoperative hormone≥ 46 ng / ml.especially for PRL type pituitary adenomas,the preoperative PRL hormone level was significantly positively correlated with Ki-67 labeling index.