[Postoperative prognosis in acromegaly: a role of immunohistochemical markers]

The aim of the investigation was to examine the markers of tumor progression in pituitary adenomas in acromegalic patients and to study their relationship to the poor postoperative predictive factors. Case histories were analyzed in 39 arcomegalic patients undergone transphenoidal adenomectomy as the method of choice at the Endocrinology Research Center, Russian Academy of Medical Sciences. The immunohistochemical technique was used to explore Ki-67, CD31, and galectin-3 in the cells of removed adenomas. Young age, high postoperative growth hormone (GH) levels, a large adenoma, and signs of its paracellular dissemination were poor postoperative predictors. Ki-67 was present In 9 (23%) of the 39 patients, CD31 in 16 (31%), galectin-3 in 11 (28%), and prolactin in 9 (23%). The preoperative GH levels were significantly higher in patients with positive immunostaining for the potential malignancy marker galectin3 and the angiogenetic marker CD31. The cell proliferation marker Ki-67 was present only in adenomas positive for prolactin. Positive immunostaining for Ki-67 and prolactin correlated with large adenoma sizes and intracavernous extension.