Liu Jiayu, He Yuhao, Zhang Xuebin, Yan Xiaoling, Huang Ying
Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin 300000, P.R. China.
Department of Neurosurgery, Peking University People's Hospital, Beijing 100044, P.R. China.
Oncol Lett. 2020 Mar;19(3):1890-1898. doi: 10.3892/ol.2020.11263. Epub 2020 Jan 8.
Pituitary adenomas (PAs) are a common subtype of intracranial tumors. The aim of the present study was to analyse the clinical and pathological features of different types of pituitary adenomas (PAs) according to the 2017 World Health Organisation Endocrine Organ Tumor Classification guidelines. The clinical data of 250 patients with PAs were collected and analysed. Differences in the incidence of invasion, recurrence and apoplexy in patients between high- and low-risk PAs were compared, as were differences in the Ki-67 index between invasive and non-invasive PAs and between recurrent PAs and non-recurrent PAs. Of the 250 cases, 45 cases were diagnosed as somatotroph adenomas, 26 cases as lactotroph adenomas, 1 case as thyrotroph adenoma, 61 cases as corticotroph adenomas, 93 cases as gonadotropin adenomas, 15 cases as null cell adenomas and 9 cases as plurihormonal adenomas. There were 5 types of high-risk pituitary adenoma identified: 17 cases of sparsely granulated somatotroph adenoma, 11 cases of lactotroph adenoma in men, 3 cases of plurihormonal PIT-1 positive adenoma and 42 cases of silent corticotroph adenoma. Crooke's cell adenoma was not identified. High-risk PAs had significantly higher rates of invasion, recurrence and apoplexy compared with that in low-risk types (P<0.001). Invasive PAs had a significantly higher Ki-67 index compared with that in non-invasive PAs (3.5±1.8 vs. 2.8±1.3; P<0.01). Recurrent PAs had a significantly higher Ki-67 index compared with that in non-recurrent PAs (3.9±1.9 vs. 2.8±1.3; P<0.001). According to the 2017 classification criteria, patients most frequently had gonadotrophin cell adenomas, followed by corticotroph adenomas and the proportion of null cell adenomas was reduced. Differences were noted in the proliferation, recurrence and apoplexy characteristics of high-risk PAs and low-risk PAs. The invasion and recurrence of PAs were found to be related to the Ki-67 index.
垂体腺瘤（PAs）是颅内肿瘤的一种常见亚型。本研究的目的是根据2017年世界卫生组织内分泌器官肿瘤分类指南分析不同类型垂体腺瘤（PAs）的临床和病理特征。收集并分析了250例垂体腺瘤患者的临床资料。比较了高危和低危垂体腺瘤患者侵袭、复发和卒中发生率的差异，以及侵袭性和非侵袭性垂体腺瘤之间、复发性和非复发性垂体腺瘤之间Ki-67指数的差异。在这250例病例中，45例被诊断为生长激素腺瘤，26例为催乳素腺瘤，1例为促甲状腺激素腺瘤，61例为促肾上腺皮质激素腺瘤，93例为促性腺激素腺瘤，15例为无功能细胞腺瘤，9例为多激素腺瘤。确定了5种高危垂体腺瘤类型：17例稀疏颗粒性生长激素腺瘤、11例男性催乳素腺瘤、3例多激素PIT-1阳性腺瘤和42例静止性促肾上腺皮质激素腺瘤。未发现克鲁克细胞腺瘤。与低危类型相比，高危垂体腺瘤的侵袭、复发和卒中发生率显著更高（P<0.001）。侵袭性垂体腺瘤的Ki-67指数显著高于非侵袭性垂体腺瘤（3.5±1.8 vs. 2.8±1.3；P<0.01）。复发性垂体腺瘤的Ki-67指数显著高于非复发性垂体腺瘤（3.9±1.9 vs. 2.8±1.3；P<0.001）。根据2017年分类标准，患者最常见的是促性腺激素细胞腺瘤，其次是促肾上腺皮质激素腺瘤，无功能细胞腺瘤的比例有所降低。高危和低危垂体腺瘤在增殖、复发和卒中特征方面存在差异。发现垂体腺瘤的侵袭和复发与Ki-67指数有关。
