Subclinical adenomas in postmortem pituitaries: classification and correlations to clinical data
Subclinical adenomas in postmortem pituitaries: classification and correlations to clinical data
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DOI：
10.1530/eje.1.02107
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发表时间：
2006-05-01
影响因子：
5.8
通讯作者：
Saeger, Wolfgang
中科院分区：
文献类型：
--
作者：
Buurman, Hilke;Saeger, Wolfgang
目的：本研究的目的是利用现代免疫染色技术检查一系列死后垂体中的垂体腺瘤，根据现行的 WHO 分类对腺瘤进行分类，并分析其与现有临床数据的可能关联。方法：在本研究中，对 1991-2004 年尸检系列中获得的 3048 例尸检病例的垂体进行了检查。结果：总共 334 个垂体瘤在316个垂体中发现了垂体腺瘤。诊断出 132 例稀疏颗粒催乳素细胞腺瘤（39.5%）、75 例无效细胞腺瘤（22.5%）和 31 例嗜酸细胞瘤。检测到 46 例 ACTH 细胞腺瘤（13.8%，27 例致密颗粒状，19 例稀疏颗粒状）和 1 例由克鲁克细胞组成的腺瘤。 22 例促性腺激素细胞腺瘤（6.6%）、7 例 GH 细胞腺瘤（4 例稀疏颗粒、3 例密集颗粒）、1 例 GH 细胞-PRL 细胞混合腺瘤、2 例 TSH 细胞腺瘤、5 例 1 型多激素腺瘤、4 例 11 型多激素腺瘤和 2 例仅含 a 亚基的腺瘤。六个腺瘤仍未分类，因为免疫组织化学的所有切片中均未包含该组织。十七个垂体包含多个肿瘤。肿瘤的整体大小直径为0.1至20毫米。在76个肿瘤尺寸≥3毫米的腺瘤（22.7%）中，只有3个肿瘤是相当于肿瘤尺寸超过10毫米的大腺瘤。对现有临床数据的评估显示，99 例高血压患者、65 例糖尿病患者、6 例甲状腺功能亢进症患者和 4 例甲状腺功能减退症患者。没有腺垂体激素分泌过多症状的报道。讨论了与临床数据的统计相关性。结论：死后垂体腺瘤与手术系列中的腺瘤在腺瘤类型和生物学行为的比例方面有所不同。
Objective: The aim of this study was to examine pituitary adenomas in a series of postmortem pituitaries by use of modern technologies of immunostaining, to classify the adenomas according to the current WHO classification and to analyse the possible associations to the-available clinical data.Methods: In this study, pituitaries of 3048 autopsy cases obtained from autopsy series of the years 1991-2004 were examined.Results: A total of 334 pituitary adenomas were found in 316 pituitaries. One hundred and thirty-two sparsely granulated prolactin cell adenomas (39.5%), 75 null cell adenomas (22.5%) and 31 oncocytomas were diagnosed. Forty-six ACTH cell adenomas (13.8%, 27 densely granulated, 19 sparsely granulated) and one adenoma composed of Crooke's cells were detected. Twenty-two gonadotroph cell adenomas (6.6%), seven GH cell adenomas (four sparsely granulated, three densely granulated), one mixed GH cell-PRL cell adenoma, two TSH cell adenomas, five plurihormonal adenoma type 1, four plurihormonal adenoma type 11 and two a-subunit-only adenomas were seen. Six adenomas remained unclassified because the tissue was not contained in all sections for immunohistochemistry. Seventeen pituitaries included multiple tumours. The overall tumour size ranged from 0.1 to 20 mm in diameter. Among 76 adenomas (22.7%), which had a tumour size of >= 3 mm, only three tumours were macroadenomas corresponding to a tumour size of more than 10 mm. The evaluation of the available clinical data showed 99 cases of hypertension, 65 cases of diabetes mellitus, six patients with hyper-thyroidism and four with hypothyroidism. No symptoms of adenohypophyseal hormone hypersecretion were reported. The statistical correlations to clinical data were discussed.Conclusions: Adenomas in postmortem pituitaries differ from those in surgical series in proportion of adenoma types and biological behaviour.