USEFULNESS OF MARKERS OF CELL-PROLIFERATION IN THE MANAGEMENT OF PITUITARY-ADENOMAS

1. Pituitary adenomas are benign and slow-growing tumours whose clinic al manifestations depend mainly on the secretory activity of the adeno matous cells. Except for prolactinomas, surgical removal of the tumour is the therapy of choice. 2. Despite extensive research on their clin ical and pathophysiological aspects, few studies have explored the onc ological characteristics of these rare lesions. Among these, the growt h fraction of pituitary adenomas has been determined by different meth ods, of which the most useful are those performed in archival material . 3. The results reported in the literature show that adrenocorticotro pic hormone-secreting tumours seem to be characterized by a higher pro liferation index than the other types of pituitary adenomas, despite t heir usually small tumour size. 4. In small series of patients radioth erapy and medical treatment with dopaminergic drugs and octreotide wer e associated with a lower proliferation index than untreated tumours. Tumour size was not correlated with the growth fraction of the pituita ry tumours, whereas invasiveness was correlated in most studies.5. Fro m a clinical point of view, however, the more promising utilization of the proliferation index seems to be in predicting the potential of re currence of the tumour, thus allowing a more rational approach to foll ow-up and further treatment of patients with pituitary adenomas.