Relevância prognóstica da expressão imuno-histoquímica dos receptores KI-67 em adenomas hipofisários

• Ano de defesa: 2016
• Autor(a) principal: Nascimento, Ana Gisélia Portela de Araújo Cortês
• Orientador(a): FARIA, Manuel dos Santos
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Maranhão
• Programa de Pós-Graduação: PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE DO ADULTO E DA CRIANÇA/CCBS
• Departamento: DEPARTAMENTO DE MEDICINA I/CCBS
• País: Brasil
• Palavras-chave em Português: Adenomas hipofisários; Antígeno Ki-67; Proliferação celular
• Palavras-chave em Inglês: Pituitary adenomas; Cell proliferation
• Área do conhecimento CNPq: Cancerologia
• Link de acesso: http://tedebc.ufma.br:8080/jspui/handle/tede/1425

Pituitary adenomas represent 10-15% of all intracranial tumors with an incidence of 1/1000 of the population. They are considered benign and mostly slow growth. Despite this, about 35% may present with invasion of parasellar compartments and a significant number have a clinically aggressive behavior with early recurrence during follow-up, despite surgery and other therapeutic approaches. Such aggressive tumors should be identified early in order to provide a more incisive treatment and / or a strict clinical and radiological follow-up, with prompt djunctive therapy institution in persistence or recurrence of these tumors. Despite these considerations, to date, no clinical, radiological and histological marker predicting such behavior has been established. This study aims to reassess the role of Ki-67 through an improved immunohistochemical technique for the expression of these antigens and correlate it to demographic and clinicopathological parameters of pituitary adenomas. This is a crosssectional study conducted from November 2015 to August 2016 were used pituitary adenoma tissue from 62 patients from the Endocrinology Service of the University of the Federal University of Maranhão Hospital. For evaluation of adenomas of medical records data were analyzed, namely: clinical and serum levels of related hormones as well as magnetic resonance imaging of the pituitary gland. To analyze the expression of Ki-67 was performed immunohistochemical technique using the anti-human monoclonal primary antibody, expressed by the percentage of labeled nuclei in the form of labeling index Ki-67. In our sample of 62 patients, 31 patients were female (50%) with a mean age at surgery of 46.2 (± 13.3) years, ranging from 16 to 73 years. Ki-67 index, as well as their median had to be higher in females, with p = 0.04 and p = 0.02, respectively. There was no predominance of expression and Ki-67 index with respect to age and diagnosis. Adenomas giant had higher median Ki-67 with respect to non giants with p = 0.04, but there was no correlation of Ki-67 with tumor invasion. The pituitary adenomas previously submitted to specific pharmacotherapy showed expression of Ki-67 lower, however, only when the somatotropinomas were analyzed separately, there was statistically significant with p = .0,03. The Ki-67 antigen, a marker of tumor proliferative activity, play an important role in pituitary adenomas. In conjunction with other biomarkers such as tumor invasion, large volume adenoma the initial presentation of patients and / or rapid tumor growth rate documentation can lead to identification of patients which show an aggressive clinical behavior, in order to conduct a multimodal therapeutic approach more effective or more strict postoperative follow-up.