TROP2, Cyclin D1, and Ki-67 as Prognostic Markers of Aggressive Pituitary Adenoma

Pituitary adenomas have highly variable biological behavior, and reliable biomarkers are needed to distinguish indolent from aggressive tumors. This study evaluates the expression of TROP2, Cyclin D1, and Ki-67 as prognostic factors in pituitary adenomas. Fifty surgically resected pituitary adenomas were analyzed retrospectively. Immunohistochemical staining for TROP2, Cyclin D1, and Ki-67 was assessed and correlated with clinicopathological variables. The Logistic regression, Kaplan-Meier, and Cox regression analyses were performed to evaluate their prognostic value for recurrence and RFS. High Ki-67 expression (≥3%), Cyclin D1 overexpression, and TROP2 overexpression were identified in 42%, 60%, and 56% of cases, respectively. All 3 biomarkers were significantly associated with larger tumor size, invasiveness, higher Knosp and Hardy classifications, tumor recurrence, and shorter RFS. In multivariate analysis, Cyclin D1 and TROP2 remained independent predictors of RFS, while invasiveness was an independent predictor of tumor recurrence. Conclusion: Ki-67, Cyclin D1, and TROP2 are closely associated with aggressive clinicopathological features in pituitary adenomas. Among these markers, Cyclin D1 and TROP2 were the strongest independent predictors of recurrence-free survival. These findings support integrating these biomarkers into prognostic assessment models to refine postoperative follow-up protocols and identify patients at increased risk of recurrence.