Ki-67 and Clinical Correlations in Patients with Resistant Prolactinomas.

OBJECTIVE

Drug resistance is the main limitation for dopamine agonist therapy with prolactinoma. Transsphenoidal surgery is an additional operation that circumvents this limitation. To characterize distinctive clinical features of resistant prolactinoma in different levels of Ki-67, a retrospective analysis of 423 patients who were diagnosed and surgically treated at Shandong Provincial Hospital Affiliated to Shandong University from January 2007 to June 2017 was performed.

METHODS

Patients were subdivided into Ki-67≥3% group (High) and Ki-67<3% group (Low) according to Ki-67 labeling values.

RESULTS

Tumors in the High group were larger (P=0.001), associated with more frequent headaches and dizziness (P=0.004), more visual impairment (P=0.008), more polyuria and polydipsia (P=0.029), and had a higher percentage of invasion (P=0.003) than patients in the Low group. However, the prolactin normalization rate in the High group was significantly lower (P=0.042). More frequent recurrence was observed in the High group (P=0.018).

CONCLUSIONS

These observations suggest the importance of investigating Ki-67 in patients with resistant prolactinoma. The treatment of resistant prolactinomas with higher level of Ki-67 is still a challenge.