Magnetic Resonance Imaging and Biological Markers in Pituitary Adenomas with Invasion of the Cavernous Sinus Space

Abstract

Objective To evaluate the magnetic resonance imaging (MRI) and biological marks in pituitary adenomas with cavernous sinus invasion.Methods The MRI features and intraoperative findings were investigated in 45 patients with pituitary adenoma,and their specimens of pituitary adenomas were analyzed for the expression of F8,Ki-67,VEGF,MMP-9,nm23,c-myc and bcl-2 immunoreactivity using immunoperoxidase staining.MVD was assessed using F8-related antigen.Results The sensitivity of MRI for predicting cavernous sinus invasion was 60%,its specificity 85%,its positive predictive value 83% and negative predictive value 63% in 45 patients with pituitary adenoma.The results of immunoreactivity revealed that MVD,Ki-67 label index (LI),the expression of VEGF and MMP-9 of invasive pituitary adenomas were significantly higher than those of noninvasive (52.52±11.18 vs 34.96±18.69,2.74±2.83 vs 1.25±1.45,4.73±0.64 vs 3.09±1.48 and 3.05±1.04 vs 0.67±0.74,P0.001,=0.039,0.001 and 0.001,respectively).The expression of nm23 of noninvasive pituitary adenomas was significantly higher than that of invasive (4.08±1.18 vs 1.55±1.52,P0.001).But c-myc LI and bcl-2 expression had no association with invasiveness of pituitary adenomas (1.07±1.54 vs 0.35±0.73,P=0.061;2.34±1.75 vs 1.66±1.79,P=0.201,respectively).Conclusion Pituitary adenomas with cavernous sinus invasion can be diagnosed by sensitive gadolinium-enhanced MRI preoperatively.MVD and the expression of Ki-67,VEGF,MMP-9 and nm23 have associations with invasiveness of pituitary adenomas to some extent.These markers may provide some useful information to the treatment of invasive pituitary adenoma.