Research Into Ultrastructure, Immunohistochemistry And The Expressions Of MVD, Nm23, Ki-67 In Pituitary Adenomas

Objective: To obtain a morphological and functional classification of pituitary adenoma, and observe the expressions of MVD, nm23, Ki-67 in pituitary adenomas and possible relationship between the three, so as to determine its biological behavior and evaluate prognosis, and help clinical treatment.Methods: Measures of ultrastructure and immunohistochemistry(SP) which examining the expressions of microvessel density, nm23 and Ki-67 were used in the 98 pituitary adenomas sampled.Results: (1) The 98 pituitary adenomas were divided into: 41(41.8%) PRL-secreting adenomas, 20(20.4%) GH-secreting adenomas, 15(15.3%) Null cell adenomas, 6(6.1%) plurihormonal adenomas, 6(6.1%) PRL-GH adenomas, 5(5.1%) ACTH adenomas, 3(3.1%) gonadotroph adenomas and 2(2.1%) acidophil stem-cell adenomas; (2) The positive expression rates of nm23 were 30.4%, 88.0% in invasive adenoma group and noninvasive adenoma group respectively. The positive expression rate of nm23 in noninvasive adenoma group was obviously higher than that in invasive adenoma group, and the difference was significant enough to be of statistical value(P<0.0l) ; (3) The labeling indexes of Ki-67 were (4.6#5.4)%, (1.7#1.3)% in invasive adenoma group and noninvasive adenoma group respectively. The labeling index of Ki-67 in invasive adenoma group was higher than that in noninvasive adenoma group, with a difference of statisticalsignificance(P<0.05) ; (4) The microvessel densities were 55.1 21.4, 36.3 15.2 in invasive adenoma group and noninvasive adenoma group respectively. The microvessel density in invasive adenoma group was obviously higher than that in noninvasive adenoma group, and the difference was significant enough to be of statistical value(P<0.01); (5) The labeling index of Ki-67 in nm23 positive group was higher than that in nm23 negative group, with a difference of statistical significance(P<0.05); The microvessel density in nm23 negative group was obviously higher than that in nm23 positive group, and the difference was significant enough to be of statistical value(P<0.01); No correlation was found between the microvessel density and the expression of Ki-67(rs=0.1361, P>0.05).Conclusions: It's a practical method to classify pituitary adenoma with a combination of multi-measures: immunohistochemistry, ultrastructure and endocrinal characteristics; Nm23, Ki-67 and microvessel density play an important role in the biological behaviour of pituitary adenoma, and there exist co-relations between the three. The examination of the three helps to determine the biological behaviour of pituitary adenoma, as well as to supervise treatment and prognostic evaluation.