Xu Jiakun, Zhang Shaolin, Su Weijie, Yang Jia, Yang Lixuan, Li Xixi
Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China.
Sci Rep. 2025 Jan 2;15(1):601. doi: 10.1038/s41598-024-84261-y.
Transcription factors (TFs), including steroidogenic factor-1 (SF-1), T-box transcription factor (TPIT) and pituitary transcription factor-1 (PIT-1), play a pivotal role in the cytodifferentiation of adenohypophysis. However, the impact of TFs on the growth patterns of nonfunctioning pituitary adenomas (NFPAs) remains unclear. This study aims to investigate the correlation between the expression of TFs and NFPAs growth patterns. Preoperative MRI in 171 patients who underwent surgery for nonfunctioning pituitary macroadenomas were analyzed to determine tumor growth patterns. Immunohistochemical staining for transcription factors PIT-1, TPIT, and SF-1 was done on all samples. Extrasellar growth was divided into three principal directions: infrasellar, suprasellar and lateral cavernous sinus invasion (CSI). Suprasellar extension was defined as tumor extension superior to the tuberculum sellae-dorsum sellae line, inferior extension as invasion through the sellar floor into the sphenoid sinus or clivus and CSI as Knosp grading score of 3 ~ 4. Statistical analysis to compare the groups was conducted using the Fisher's exact test and t-test. TPIT-expressing tumors were more likely to exhibit combined infrasellar extension (55.17 vs 17.70%, p < 0.0001), as well as isolated infrasellar extension (18.97 vs 0%, p < 0.0001) compared to SF-1-expressing tumors. Conversely, SF-1-expressing tumors were more likely to exhibit combined suprasellar extension (92.92 vs 77.59%, p = 0.0061), as well as isolated suprasellar extension (75.22 vs 41.38%, p < 0.0001). TPIT-expressing tumors had a significantly higher CSI invasion (55.17 vs 35.40%, p = 0.0148). The mean maximal tumor diameter in TPIT and SF-1 macroadenomas was similar (28 vs 26 mm, p = 0.1213). The expression of TFs affects the extrasellar growth pattern of NFPAs. TPIT tumors exhibit a higher propensity for bone invasion and CSI, while SF-1 tumors tend to extend into the suprasellar region. Isolated infrasellar extension is specific to TPIT tumors and can serve as a radiologic sign to distinguish between TPIT tumors and SF-1 tumors.
转录因子（TFs），包括类固醇生成因子-1（SF-1）、T盒转录因子（TPIT）和垂体转录因子-1（PIT-1），在腺垂体的细胞分化中起关键作用。然而，TFs对无功能垂体腺瘤（NFPAs）生长模式的影响仍不清楚。本研究旨在探讨TFs表达与NFPAs生长模式之间的相关性。分析了171例接受无功能垂体大腺瘤手术患者的术前MRI，以确定肿瘤生长模式。对所有样本进行转录因子PIT-1、TPIT和SF-1的免疫组织化学染色。鞍外生长分为三个主要方向：鞍下、鞍上和外侧海绵窦侵袭（CSI）。鞍上延伸定义为肿瘤延伸至鞍结节-鞍背线以上，向下延伸定义为通过鞍底侵入蝶窦或斜坡，CSI定义为Knosp分级评分3至4级。使用Fisher精确检验和t检验进行组间比较的统计分析。与表达SF-1的肿瘤相比，表达TPIT的肿瘤更易出现合并鞍下延伸（55.17%对17.70%，p<0.0001）以及孤立性鞍下延伸（18.97%对0%，p<0.0001）。相反，表达SF-1的肿瘤更易出现合并鞍上延伸（92.92%对77.59%，p=0.0061）以及孤立性鞍上延伸（75.22%对41.38%，p<0.0001）。表达TPIT的肿瘤有显著更高的CSI侵袭率（55.17%对35.40%，p=0.0148）。TPIT和SF-1大腺瘤的平均最大肿瘤直径相似（28mm对26mm，p=0.1213）。TFs的表达影响NFPAs的鞍外生长模式。TPIT肿瘤表现出更高的骨侵袭和CSI倾向，而SF-1肿瘤倾向于延伸至鞍上区域。孤立性鞍下延伸是TPIT肿瘤所特有的，可作为区分TPIT肿瘤和SF-1肿瘤的影像学标志。
