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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Baseline and postoperative hormonal assessments, pituitary imaging features, pathological classification, metabolic comorbidity, and follow-up outcome were collected and analyzed.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>SGH-PAs represent approximately 3% of nonfunctioning PAs undergoing surgery. Multiple anterior pituitary hormones are commonly co-expressed. 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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.</p><p><strong>Results: </strong>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. 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引用次数: 0
摘要
目的：探讨垂体腺瘤（SGH-PAs）的临床病理特征和代谢特征。方法：采用单中心回顾性研究，从2019-2023年北京协和医院1387例手术治疗的无功能PAs中鉴定出SGH-PAs。对照组包括407例连续无功能的促性腺激素垂体腺瘤（NFG-PAs）和90例年龄和性别匹配的肢端肥大症患者。收集和分析基线和术后激素评估、垂体成像特征、病理分类、代谢合并症和随访结果。结果：1387例非功能性pa中鉴定出45例SGH-PA（3.2%）。病理亚型包括嗜酸干细胞腺瘤18例（40%），未成熟PIT1谱系肿瘤11例（24%），稀疏颗粒生长激素瘤5例，乳腺生长发育瘤5例，成熟多激素PIT1谱系肿瘤4例，多激素垂体瘤2例。与对照组相比，SGH-PAs在基线或2年复发时表现出适度的增殖升高（肢端肥大症的中位Ki-67 %对2% [p = 0.002]和NFG-PAs [p = 0.011]），肿瘤侵袭性没有明显增加（Knosp 3-4：各组间20-30%）。基线代谢合并症与高血压（22%）和糖尿病（8.9%）的NFG-PA谱相似，血脂异常患病率降低（17.8% vs. 33.4%, p = 0.049）。在77人年的随访中，未发现SGH-PAs转化为肢端肥大症的病例。结论：SGH-PAs约占手术中无功能PAs的3%。多种垂体前叶激素通常共表达。这些肿瘤可能更具增生性，但放射学的基线侵袭性和短期复发率相似。
Silent growth hormone pituitary adenomas: a single-center study.
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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