Nuclear accumulation of basic fibroblast growth factor as a predictor for the recurrence of pituitary adenomas

Although pituitary adenomas often recur, a reliable predictor for their recurrences has not yet been established. The aim of this study is to assess the utility of the nuclear accumulation of basic fibroblast growth factor (bFGF) as a predictor for the recurrence of pituitary adenomas. We studied 64 patients who had primary pituitary adenomas and underwent operations. The immunohistochemistry for bFGF and MIB-1 was retrospectively examined in paraffin-embedded tissues. The bFGF immunoreactivity in the cytoplasm was assigned one of four grades and the bFGF immunoreactivity in the nucleus was recorded as the bFGF nuclear index (NI), which was calculated as a percentage of tumor cells with the bFGF immunoreactivity in the nuclei in more than 1000 tumor cells. Recurrent adenomas were found in 7 patients during follow-up periods ranging from 8 to 134 months (mean: 57.3). Kaplan-Meier analysis demonstrated that high bFGF NI (>30%) correlated with poor recurrence free rate (p < 0.02). We assessed the relative contribution of bFGF NI to recurrence free by using multivariate (Cox's proportional hazards model) analyses with variable factors. Multivariate analysis showed that only bFGF NI was a potential predictor of recurrence free, independent of all other variables. High bFGF NI (>30%) had a relative risk of 8.9, with a 95% confidence interval of 1.0-74.9 (p < 0.05). We suggest that the bFGF NI may be a potentially useful predictor for the recurrence of pituitary adenomas.