Proposal of a new clinical cyto-functional classification of pituitary adenomas

垂体腺瘤的分类历史上是基于着色的亲和性，其次是基于超微结构和免疫组织化学。目前的技术发展需要新的分类垂体腺瘤，整合这些众多的信息以及临床信息。为此，我们提出了一个新的临床细胞功能分类，它是基于临床表现，并结合生物学，图像，功能和超微结构的信息垂体腺瘤。我们用免疫组化（IHC）、原位杂交（ISH）和电镜检查了约600例手术切除的腺瘤组织。通过免疫组化和超微结构技术，大多数生长激素分泌腺瘤呈现多激素表达，并且已经表明垂体特异性转录因子Pit-1可能在生长激素、促甲状腺激素和催乳素分泌腺瘤的功能分化和多功能性中起作用。临床上无功能性腺瘤已经证实了促性腺激素的分泌以及IHC和ISH的激素表达之间的下降。此外，我们还研究了各种转录本的表达，包括下丘脑激素，下丘脑激素受体，雌激素受体，维甲酸X受体，这些被认为在肿瘤发生和细胞分化中具有重要作用，使用原位聚合酶链反应。将分子生物学技术应用于临床细胞功能分类，有助于更好地了解垂体腺瘤的发病机制、病理生理和功能。

Pituitary adenomas have been classified historically on the basis of tinctorial affinities, followed by the basis of ultrastructure and immunohistochemistry. The current development of technologies necessitate the new classification of pituitary adenomas which integrates these numerous informations as well as the clinical informations. For this purpose, we suggest a new clinical cytofunctional classification of pituitary adenomas, which is based on clinical manifestations and integrates the information on biology, images, function and ultrastructure. We have examined about 600 surgically obtained adenoma tissues by immunohistochemistry (IHC), in situ hybridization (ISH) and electronmicroscopy. By IHC and ultrastructural techniques, most GH-producing adenomas present multihormonal expressions and it has been suggested that pituitary specific transcriptional factor Pit-1 may have a role in the functional differentiation and the multihormonality of GH, TSH and PRL secreting adenomas. Clinically non-functioning adenomas have demonstrated gonadotropin secretion and the descrepancy between hormonal expression by IHC and gene expression by ISH.Furthermore, we have investigated the expression of various transcripts including hypothalamic hormones, hypothalamic hormone receptors, estrogen receptor, retinoid X receptor, which regarded to have important eoles on tumorigenesis and cell differentiation, using in situ polymerase chain reaction. Introduction of the molecular biotechniques in clinical cyto-functional classification is expected to provide a better understanding of the pathogenesis, pathophysiologies and functions of pituitary adenomas.