Tongxin Xiao, Xinxin Mao, Xueqing Zheng, Ran Li, Linjie Wang, Yong Yao, Kan Deng, Fengying Gong, Hui Pan, Lin Lu, Huijuan Zhu, Lian Duan
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引用次数: 0
Abstract
Purpose: To characterize the clinicopathological features and metabolic profiles of silent growth hormone pituitary adenomas (SGH-PAs).
Methods: The single-center retrospective study identified SGH-PAs from 1387 surgically treated non-functioning PAs at Peking Union Medical College Hospital (2019-2023). Controls included 407 consecutive cases with non-functioning gonadotropin pituitary adenomas (NFG-PAs) and 90 age and gender-matched acromegaly patients. Baseline and postoperative hormonal assessments, pituitary imaging features, pathological classification, metabolic comorbidity, and follow-up outcome were collected and analyzed.
Results: 45 cases of SGH-PA (3.2%) were identified from 1387 non-functioning PAs. The pathological subtypes included 18 (40%) acidophil stem cell adenomas, 11(24%) immature PIT1-lineage tumors, 5 sparsely granulated GH tumors, 5 mammosomatotroph tumors, 4 mature plurihormonal PIT1 lineage tumors, and 2 plurihormonal pituitary tumors. Compared to controls, SGH-PAs showed modestly elevated proliferation (median Ki-67 3% vs. 2% in both acromegaly [p = 0.002] and NFG-PAs [p = 0.011]) without outstanding increases in tumor invasiveness (Knosp 3-4: 20-30% across groups) at baseline or 2-year recurrence. Baseline metabolic comorbidities paralleled NFG-PA profiles for hypertension (22%) and diabetes (8.9%), with reduced dyslipidemia prevalence (17.8% vs. 33.4%, p = 0.049). No case of SGH-PAs transforming into acromegaly was confirmed during 77 person-years of follow-up.
Conclusions: SGH-PAs represent approximately 3% of nonfunctioning PAs undergoing surgery. Multiple anterior pituitary hormones are commonly co-expressed. These tumors may be more proliferative, but the baseline aggressiveness in radiology and short-term recurrence rates are similar.
期刊介绍：
Pituitary is an international publication devoted to basic and clinical aspects of the pituitary gland. It is designed to publish original, high quality research in both basic and pituitary function as well as clinical pituitary disease.
The journal considers:
Biology of Pituitary Tumors
Mechanisms of Pituitary Hormone Secretion
Regulation of Pituitary Function
Prospective Clinical Studies of Pituitary Disease
Critical Basic and Clinical Reviews
Pituitary is directed at basic investigators, physiologists, clinical adult and pediatric endocrinologists, neurosurgeons and reproductive endocrinologists interested in the broad field of the pituitary and its disorders. The Editorial Board has been drawn from international experts in basic and clinical endocrinology. The journal offers a rapid turnaround time for review of manuscripts, and the high standard of the journal is maintained by a selective peer-review process which aims to publish only the highest quality manuscripts. Pituitary will foster the publication of creative scholarship as it pertains to the pituitary and will provide a forum for basic scientists and clinicians to publish their high quality pituitary-related work.
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