Lee Cheng-Chi, Huang Yin-Cheng, Pai Ping-Ching, Jung Shih-Ming, Hsu Peng-Wei, Wang Yu-Chi, Chuang Chi-Cheng
Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan.
Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.
Discov Oncol. 2025 May 3;16(1):665. doi: 10.1007/s12672-025-02442-1.
Partial resection of pituitary neuroendocrine tumor often results in residual tumor that increases the risk of recurrence. This pilot study aimed to determine whether the center and periphery of pituitary macroadenomas expressed different levels of biomarkers of invasiveness.
This prospective pilot study included 30 patients with newly diagnosed pituitary macroadenomas (≥ 10 mm) who underwent transsphenoidal surgery (2012-2013). Patients were randomly assigned to the sorted group (n = 15), where central and peripheral tumor zones were separately resected, or the unsorted group (n = 15), where tumors were resected without zonal distinction. Immunohistochemistry (IHC) quantified Ki-67, HIF-1α, CD31, CD34, CD105, and VEGF expression. Differences in biomarker expression across tumor zones, Knosp grade, and functional status were analyzed using the Wilcoxon signed-rank test and other statistical methods.
In the sorted group, the peripheral zone exhibited significantly higher immunoreactivities of Ki-67, HIF-1α, CD34, and VEGF (all p < 0.01) compared to the central zone, while CD31 and CD105 showed no significant differences. Subgroup analysis showed that in Knosp grade 0-2 tumors, CD34 and VEGF were elevated in the peripheral zone, whereas in Knosp grade 3-4 tumors, Ki-67, HIF-1α, and CD34 were significantly higher (all p < 0.05). In functioning adenomas, HIF-1α and CD34 were increased in the peripheral zone, while in non-functioning adenomas, Ki-67, HIF-1α, CD34, and VEGF were significantly elevated.
This pilot study revealed that biomarkers of invasiveness are expressed at higher levels in the peripheral zone of pituitary macroadenomas. Larger studies are needed to confirm these findings and evaluate their clinical significance.
垂体神经内分泌肿瘤部分切除术后常残留肿瘤，增加复发风险。本前瞻性初步研究旨在确定垂体大腺瘤的中心和周边区域侵袭性生物标志物的表达水平是否存在差异。
本前瞻性初步研究纳入了30例新诊断的垂体大腺瘤（≥10mm）患者，这些患者于2012年至2013年接受了经蝶窦手术。患者被随机分为分选组（n = 15），该组分别切除肿瘤的中心和周边区域，或未分选组（n = 15），该组切除肿瘤时不区分区域。免疫组织化学（IHC）定量检测Ki-67、HIF-1α、CD31、CD34、CD105和VEGF的表达。采用Wilcoxon符号秩和检验及其他统计方法分析肿瘤区域、Knosp分级和功能状态之间生物标志物表达的差异。
在分选组中，与中心区域相比，周边区域的Ki-67、HIF-1α、CD34和VEGF免疫反应性显著更高（均p < 0.01），而CD31和CD105无显著差异。亚组分析显示，在Knosp 0-2级肿瘤中，周边区域的CD34和VEGF升高，而在Knosp 3-4级肿瘤中，Ki-67、HIF-1α和CD34显著更高（均p < 0.05）。在功能性腺瘤中，周边区域的HIF-1α和CD34增加，而在无功能性腺瘤中，Ki-67、HIF-1α、CD34和VEGF显著升高。
本初步研究表明，垂体大腺瘤周边区域侵袭性生物标志物的表达水平更高。需要开展更大规模的研究来证实这些发现并评估其临床意义。
