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垂体密颗粒和稀疏颗粒生长激素细胞瘤的临床病理分析。

Clinicopathological Analysis of Densely and Sparsely Granulated Somatotroph Tumors of Pituitary.

机构信息

Department of Pathology, Ningbo Clinical Pathology Diagnosis Center, Ningbo, China.

Department of Pathology, Ningbo Clinical Pathology Diagnosis Center, Ningbo, China.

出版信息

World Neurosurg. 2024 May;185:e713-e720. doi: 10.1016/j.wneu.2024.02.115. Epub 2024 Feb 24.

DOI:10.1016/j.wneu.2024.02.115
PMID:38408701
Abstract

OBJECTIVE

Somatotroph tumors are the second most common type of pituitary neuroendocrine tumors, which can be further classified into 2 subtypes-densely granulated somatotroph tumors (DGSTs) and sparsely granulated somatotroph tumors (SGSTs). The aim of this study was to investigate the clinical significance of the 2 subtypes in a retrospective analysis.

METHODS

From the database of the Ningbo Clinical Pathology Diagnosis Center, we collected patients diagnosed with pituitary somatotroph tumors. We then compiled pertinent clinical and radiological data and proceeded with histopathological examination involving hematoxylin-eosin staining and immunohistochemical staining. Subsequent analysis compared the 2 subtypes using either χ test or Fisher exact test.

RESULTS

We analyzed 40 cases of somatotroph tumors, 18 cases DGSTs and 22 SGSTs. Male-to-female ratio was 5:4 for DGSTs and 4:7 for SGSTs. Mean age was 52.83 years for DGSTs and 47.18 years for SGSTs. Statistically significant differences were observed between the DGST and SGST groups in invasiveness (P = 0.0267) and postoperative remission (P = 0.007). Cells of both DGSTs and SGSTs exhibited coexpression of PIT1, growth hormone, and CAM5.2, although the patterns of CAM5.2 expression differed between the 2 subtypes.

CONCLUSIONS

The efficacy of CAM5.2 staining in distinguishing between DGSTs and SGSTs was demonstrated. SGSTs, with their increased invasiveness and lower remission rate, are a high-risk subtype. The histological subtype of somatotroph tumors plays a crucial role in guiding treatment decisions and prognostic evaluation in affected patients.

摘要

目的

生长激素细胞瘤是第二常见的垂体神经内分泌肿瘤,可进一步分为致密颗粒型生长激素细胞瘤(DGST)和稀疏颗粒型生长激素细胞瘤(SGST)。本研究旨在通过回顾性分析探讨这两种亚型的临床意义。

方法

从宁波临床病理诊断中心的数据库中收集诊断为垂体生长激素细胞瘤的患者。我们编译了相关的临床和影像学数据,并进行了组织病理学检查,包括苏木精-伊红染色和免疫组织化学染色。随后的分析使用 χ 检验或 Fisher 确切检验比较两种亚型。

结果

我们分析了 40 例生长激素细胞瘤患者,其中 18 例为 DGST,22 例为 SGST。DGST 的男女比例为 5:4,SGST 为 4:7。DGST 的平均年龄为 52.83 岁,SGST 为 47.18 岁。DGST 和 SGST 组在侵袭性(P=0.0267)和术后缓解(P=0.007)方面存在统计学显著差异。DGST 和 SGST 的细胞均表达 PIT1、生长激素和 CAM5.2,但两种亚型的 CAM5.2 表达模式不同。

结论

CAM5.2 染色在区分 DGST 和 SGST 方面具有良好的效果。SGST 侵袭性增加,缓解率降低,属于高风险亚型。生长激素细胞瘤的组织学亚型在指导治疗决策和评估患者预后方面具有重要作用。

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