Scheithauer Bernd W, Gaffey Thomas A, Lloyd Ricardo V, Sebo Thomas J, Kovacs Kalman T, Horvath Eva, Yapicier Ozlem, Young William F, Meyer Fredric B, Kuroki Tamatsu, Riehle Darren L, Laws Edward R
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Neurosurgery. 2006 Aug;59(2):341-53; discussion 341-53. doi: 10.1227/01.NEU.0000223437.51435.6E.
To examine relationships between pituitary tumors and lesion size, invasiveness, resectability, deoxyribonucleic acid ploidy, cell cycle profile, mitotic activity, and immunoreactivity for MIB-1, proliferating cell nuclear antigen (PCNA), p27Kip1, and p53.
One hundred fifty-three adenomas of most pathological subtypes, including 20 medically treated and prolactin and growth hormone-containing tumors, as well as 10 premetastatic tumors and 13 pituitary carcinomas, were studied.
Significant (P < 0.05) differences were noted between functional versus nonfunctional adenomas (percent aneuploidy, percent S phase, p27Kip1 labeling indices [LI], male sex, tumor size, and frequency of visual disturbance); Cushing's versus silent adrenocorticotropin adenomas (percent hypertetraploidy, p53 LI, tumor size, visual disturbance, and resectability); untreated versus medically treated prolactin cell adenomas (MIB-1 LI, p53 LI, and resectability); untreated versus medically treated growth hormone-containing adenomas (percent diploidy, percent S phase, MIB-1 LI, p53 LI, and p27 LI); untreated prolactin cell adenomas versus premetastatic tumors (percent hypertetraploidy, PCNA LI, p53 LI, invasiveness, and resectability); untreated growth hormone-containing adenomas versus premetastatic tumors (percent diploidy, percent S phase, PCNA LI, p53 LI, invasiveness, and resectability); Cushing's adenomas versus premetastatic tumors (percent diploidy, percent hypertetraploidy, percent S phase, MIB-1 LI, p53 LI, tumor size, invasiveness, visual disturbance, and resectability); Nelson's adenomas versus premetastatic tumors (p53 LI, tumor size, invasiveness, and resectability); silent adenomas as a whole versus nonfunctional adenomas (percent nondiploid, percent S phase, invasiveness, and respectability); silent adrenocorticotropin adenomas I and II versus silent adenoma Subtype III (invasiveness); silent adrenocorticotropin adenoma Subtypes I and II versus premetastatic tumors (MIB-1 LI and invasiveness); silent adenoma Subtype III versus premetastatic tumors (PCNA and p53 LI); and premetastatic tumors versus metastatic pituitary carcinomas (MIB-1 LI).
Only trends toward differences were noted between Cushing's versus Nelson's adenomas and between prolactinomas of reproductive female patients versus those of menopausal female patients and male patients. Too few "atypical adenomas" were encountered to permit their comparison with premetastatic tumors, but our results suggest that most pituitary carcinomas arise by malignant transformation from adenomas.
研究垂体肿瘤与病变大小、侵袭性、可切除性、脱氧核糖核酸倍体、细胞周期分布、有丝分裂活性以及MIB-1、增殖细胞核抗原（PCNA）、p27Kip1和p53免疫反应性之间的关系。
研究了153例大多数病理亚型的腺瘤，包括20例接受药物治疗的泌乳素瘤和生长激素瘤，以及10例转移前肿瘤和13例垂体癌。
功能性与非功能性腺瘤之间存在显著（P<0.05）差异（非整倍体百分比、S期百分比、p27Kip1标记指数[LI]、男性、肿瘤大小和视力障碍频率）；库欣综合征与无功能促肾上腺皮质激素腺瘤之间（超四倍体百分比、p53 LI、肿瘤大小、视力障碍和可切除性）；未治疗与药物治疗的泌乳素细胞腺瘤之间（MIB-1 LI、p53 LI和可切除性）；未治疗与药物治疗的生长激素腺瘤之间（二倍体百分比、S期百分比、MIB-1 LI、p53 LI和p27 LI）；未治疗的泌乳素细胞腺瘤与转移前肿瘤之间（超四倍体百分比、PCNA LI、p53 LI、侵袭性和可切除性）；未治疗的生长激素腺瘤与转移前肿瘤之间（二倍体百分比、S期百分比、PCNA LI、p53 LI、侵袭性和可切除性）；库欣腺瘤与转移前肿瘤之间（二倍体百分比、超四倍体百分比、S期百分比、MIB-1 LI、p53 LI、肿瘤大小、侵袭性、视力障碍和可切除性）；尼尔森腺瘤与转移前肿瘤之间（p53 LI、肿瘤大小、侵袭性和可切除性）；整体无症状腺瘤与非功能性腺瘤之间（非二倍体百分比、S期百分比、侵袭性和可切除性）；无症状促肾上腺皮质激素腺瘤I和II与无症状腺瘤亚型III之间（侵袭性）；无症状促肾上腺皮质激素腺瘤亚型I和II与转移前肿瘤之间（MIB-1 LI和侵袭性）；无症状腺瘤亚型III与转移前肿瘤之间（PCNA和p53 LI）；以及转移前肿瘤与转移性垂体癌之间（MIB-1 LI）。
仅发现库欣腺瘤与尼尔森腺瘤之间以及生育期女性泌乳素瘤与绝经后女性和男性泌乳素瘤之间存在差异趋势。遇到的“非典型腺瘤”太少，无法与转移前肿瘤进行比较，但我们的结果表明，大多数垂体癌是由腺瘤恶变而来。
