Eremkina A K, Dzeranova L K, Pigarova E K, Mokrysheva N G, Dedov I I
National Medical Research Center for Endocrinology, Ministry of Health of Russia, Moscow, Russia.
Arkh Patol. 2019;81(1):71-78. doi: 10.17116/patol20198101171.
Non-functioning pituitary adenomas (NFPAs) account for about 30% of all pituitary tumors. NFPAs are characterized by the lack of secretory potential or its weak expression insufficient for determination of the blood level of adenohypophyseal tropic hormones and for development of a specific clinical picture. Morphologically, NFPAs are a heterogeneous group of tumors, the classification of which was previously based only on immunoreactivity for pituitary tropic hormones. The WHO revised its Classification of Tumors of Endocrine Organs (4th edition) in 2017. The main changes relate to adenohypophysial-cell lineage for the designation of adenomas into subtypes. The introduction of transcription factor antibodies has become a fundamentally new approach to the classification of NFPAs, which is necessary to recognize less differentiated tumor types. This paper provides information on the new histopathological classification of pituitary adenomas, on the theories of silent adenomas, and on the proliferative and prognostic markers of NFPAs.
无功能垂体腺瘤(NFPAs)约占所有垂体肿瘤的30%。无功能垂体腺瘤的特征是缺乏分泌潜能或其弱表达不足以测定腺垂体促激素的血水平以及不足以形成特定的临床表现。形态学上,无功能垂体腺瘤是一组异质性肿瘤,其分类以前仅基于对垂体促激素的免疫反应性。世界卫生组织于2017年修订了其《内分泌器官肿瘤分类》(第4版)。主要变化涉及将腺瘤分为亚型的腺垂体细胞谱系。转录因子抗体的引入已成为无功能垂体腺瘤分类的一种全新方法,这对于识别分化程度较低的肿瘤类型是必要的。本文提供了关于垂体腺瘤新的组织病理学分类、沉默腺瘤理论以及无功能垂体腺瘤增殖和预后标志物的信息。