Abstract
The characteristics of 56 cases of pituitary adenoma were analyzed to determine the relationship between tumor size, intratumoral hemorrhage, percentage of cells expressing cmyc or bcl‐2 protein (c‐Myc or Bcl‐2), Ki‐67 labeling index, pituitary hormone production, and apoptosis index. Spearman's rank correlation analysis revealed significant relationships between Ki‐67 labeling index and percentage of c‐Myc‐labeled cells (θ= 0.364, P= 0.007), percentage of c‐Myc‐labeled cells and percentage of Bcl‐2‐labeled cells (θ= 0.453, P= 0.001), Ki‐67 labeling index and percentage of Bcl‐2‐labeled cells (θ= 0.441, P= 0.001), percentage of Bcl‐2‐labeled cells and the number of pituitary hormones produced (θ= 0.40, P= 0.004), and percentage of c‐Myc‐labeled cells and the number of pituitary hormones produced (θ= 0.39, P= 0.005). Multiple regression analysis revealed that the percentage of c‐Myc‐labeled cells was significantly influenced (R2= 0.37, P < 0.0001) by Ki‐67 labeling index (t= 3.630, P= 0.0006), the number of pituitary hormones produced (t= 0.261, P= 0.0304), and the percentage of Bcl‐2‐labeled cells (t= 1.112, P= 0.2711). Multiple regression analysis also showed that Ki‐67 labeling index was significantly influenced (R2= 0.34, P < 0.0001) by the percentage of c‐Myc‐labeled cells (t= 3.163, P= 0.0026), the percentage of Bcl‐2‐labeled cells (t= 2.041, P= 0.0463), and tumor size (t= 1.714, P= 0.092). Tumor size was proved to be significantly influenced (R2= 0.10, P= 0.0242) by Ki‐67 labeling index (t= 2.067, P= 0.0437) and apoptosis index (t= 1.266, P= 0.0930). Since apoptosis index has no significant correlation with any of the above variables by Spearman's rank correlation analysis, tumor growth is well represented by the Ki‐67 labeling index. The equation (Ki‐67 labeling index) =–1.156 + 0.041 (percentage of c‐Myc‐labeled cells) + 0.014 (percentage of Bcl‐2‐labeled cells) + 0.037 (maximum diameter of the adenoma) indicates that large pituitary adenomas with a high percentage of cells expressing both c‐Myc and Bcl‐2 will have high proliferative activity. Therefore, the interaction of c‐Myc and Bcl‐2 is important in inducing tumor growth in large pituitary adenoma.
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