Mìžnarodnij Endokrinologìčnij Žurnal (Aug 2020)

Markers of aggressiveness of non-functional pituitary adenomas with invasive growth. Literature review

  • Yu.M. Urmanova,
  • M.B. Mirtukhtaeva

DOI
https://doi.org/10.22141/2224-0721.16.5.2020.212746
Journal volume & issue
Vol. 16, no. 5
pp. 421 – 426

Abstract

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Non-functional pituitary adenomas are a morphologically heterogeneous group and are subdivided into silent adenomas that have immunoreactivity to tropic hormones and are similar in structure to typical adenocytes but do not lead to the development of clinical signs of hormonal hypersecretion (silent gonadal, cortical-, thyroid and mammotropinomas), and tumors that do not have specific markers and are similar to adenohypophyseal cells (zero-cell tumors and oncocytomas). According to the studies conduc­ted, all types of silent adenomas have different biological activity, secretory potential, and postoperative outcomes. Active detection of silent pituitary adenomas during immunohistochemical analysis not only allows identifying patients at high risk of disease recurrence but also developing optimal treatment and follow-up tactics, determining indications and evaluating the feasibility of drug and radiation therapy after a neurosurgical intervention. The review article is devoted to the search for prognostic markers of invasive growth of inactive pituitary adenomas. A high level of Ki-67 can be considered as an independent factor and a marker of poor prognosis in pituitary adenomas. The patients with adenomas with high proliferative activity were more often found to develop invasive growth of the adenoma, as well as its malignant transformation — the development of adenocarcinoma. This marker does not depend on other negative prognostic signs — the age and sex of a patient, the adenoma size. Besides, an increase in the proliferation level is more often observed in somatotropinomas and prolactinomas. In recent years, the concept of the cellular and molecular biology of pituitary tumors has changed significantly. It is known that transcription factors regulate the transformation of progenitor cells into mature secretory cells during embryogenesis. Therefore, the search for prognostic criteria for adenomas continues.

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