van der Hoeven Loren S, Slagboom Tessa N A, Malekzadeh Arjan, Hoogmoed Jantien, Drent Madeleine L, Aronica Eleonora, Stenvers Dirk Jan, Pereira Alberto M
Amsterdam UMC, University of Amsterdam, Department of Endocrinology and Metabolism, Amsterdam Gastroenterology Endocrinology and Metabolism (AGEM), 1105 AZ, Amsterdam, the Netherlands.
Amsterdam UMC, University of Amsterdam, Department of Endocrinology and Metabolism, Pituitary Center Amsterdam, 1105 AZ, Amsterdam, the Netherlands.
J Clin Endocrinol Metab. 2025 Jun 17;110(7):e2362-e2382. doi: 10.1210/clinem/dgaf112.
Immunohistochemistry (IHC) of cell lineage-specific transcription factors (TFs) has been added to the histopathological classification of pituitary adenomas since 2017, resulting in new histopathological subtypes of TF+/hormone-non-functioning pituitary adenomas (NFPAs) and a reduction in the prevalence of null cell adenomas (NCAs).
This work aimed to evaluate associations between expression of cell lineage-specific TFs by IHC and radiological invasion and prognosis of NFPAs.
A literature search in Medline, Embase, and CENTRAL was performed from inception up to July 11, 2023.
Eligible studies were cohort studies reporting on radiological invasion, recurrence, and/or radiotherapy in patients with NFPAs who tested positive for one cell lineage-specific TF or negative for all 3. Finally, 27 out of 1985 studies were included.
Two authors independently extracted data and critically appraised risk of bias using the Quality In Prognostic Studies (QUIPS) tool.
Random-effects inverse variance models were used to pool effect sizes. Prevalence rate ratios (PRRs) were calculated using the Mantel-Haenszel method. Cavernous sinus invasion was more prevalent in NCAs and TPIT+ NFPAs compared with SF1+ NFPAs (PRR 1.60; 95% CI, 1.22-2.08, I2 10%, 95% prediction interval [PrI] 1.23-2.06; P = .0036, and PRR 1.43; 95% CI, 1.21-1.70, I2 0%, 95% PrI 1.17-1.76; P = .0017, respectively), and in NCAs compared with PIT1+ (PRR 1.44; 95% CI, 1.01-2.06, I2 0%, 95% PrI 0.83-2.50; P = .0454). A limited number of studies precluded data syntheses of recurrence and radiotherapy.
The use of cell lineage-specific TFs by IHC enables to detect histopathological subtypes of NFPAs with distinct clinical behavior.
自2017年以来，细胞谱系特异性转录因子（TFs）的免疫组织化学（IHC）已被纳入垂体腺瘤的组织病理学分类，从而产生了TF+ /激素无功能垂体腺瘤（NFPAs）的新组织病理学亚型，并降低了无功能细胞腺瘤（NCAs）的患病率。
本研究旨在评估通过免疫组化检测细胞谱系特异性转录因子的表达与NFPAs的放射学侵袭和预后之间的关联。
对Medline、Embase和CENTRAL进行文献检索，检索时间从数据库建立至2023年7月11日。
符合条件的研究为队列研究，报告了检测一种细胞谱系特异性TF呈阳性或所有3种均呈阴性的NFPAs患者的放射学侵袭、复发和/或放疗情况。最终，从1985项研究中纳入了27项。
两位作者独立提取数据，并使用预后研究质量（QUIPS）工具严格评估偏倚风险。
采用随机效应逆方差模型汇总效应量。采用Mantel-Haenszel方法计算患病率比（PRRs）。与SF1+ NFPA相比，海绵窦侵袭在NCA和TPIT+ NFPA中更为常见（PRR 1.60；95% CI，1.22 - 2.08，I2 10%，95%预测区间[PrI] 1.23 - 2.06；P = .0036，以及PRR 1.43；95% CI，1.21 - 1.70，I2 0%，95% PrI 1.17 - 1.76；P = .0017），与PIT1+相比，在NCA中更常见（PRR 1.44；95% CI，1.01 - 2.06，I2 0%，95% PrI 0.83 - 2.50；P = .0454）。由于研究数量有限，无法对复发和放疗进行数据综合分析。
通过免疫组化使用细胞谱系特异性转录因子能够检测出具有不同临床行为的NFPAs组织病理学亚型。
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