RESULTS OF THE INTEGRATED RISK ANALYSISRECURRENCE OF GROWTH OF INACTIVE PITUITARY ADENOMAS IN THE POSTOPERATIVE PERIOD

Abstract

The aim of the study was to perform an integrated analysis of risk factors for recurrence of non-functional pituitary adenomas (NFPA) in the postoperative period. Materials and methods of the study. We studied 20 patients with NFPA (group 1 - 10 pituitary macroadenomas and group 2 - 10 giant pituitary adenomas) who underwent transnasal pituitary adenomectomy. All patients underwent examinations, including fundus examination, visual field measurement every 3 months, studies of the levels of STH, IGF-1, LH, FSH, ACTH, TSH, prolactin, free thyroxine, cortisol, as well as immunohistochemical studies of operated patients to determine the levels of Ki67, p53 expression. Results.The analysis showed that the most valuable predictors of tumor recurrence in NFPA are the Ki-67 labeling index ≥4% (OR = 3.67), brain invasion (3.34), suprasellar invasion (OR = 3.24), and disease duration (2.95). Genetic predisposition is also significant in the development of tumor recurrence. The frequency of the hereditary factor for NAG is 78.78% (OR = 2.51). Conclusions. 1. The immunohistochemical (IHC) studies showed a significant correlation between the Ki-67 marker, tumor size, and invasiveness in both groups. This marker should be used as a prognostic criterion for recurrence of growth and invasive growth of NFPA Using logistic regression analysis (LRA), we were able to show that all four criteria (Ki-67 (p < 0.001); OR 5.2 // p53 (p < 0.001); OR 2.1 // invasiveness (p < 0.001); OR 8.2)) were significant for the group with giant NAG and a reliable correlation was found between them (p < 0.001).