使用世界卫生组织2022年分类的非功能性垂体神经内分泌瘤的临床病理学研究
Chariene Shao-Lin Woo1, Ronnie Siu-Lun Ho2, Grace Ho3
1Department of Medicine, School of Clinical Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Frontiers in endocrinology
|May 17, 2024
概括
世卫组织2022年分类改进了使用转录因子对 pituitary神经内分泌瘤 (PitNET) 的诊断. 这个新系统有效地分类了不起作用的PitNET,预测了患者的结果和复发风险.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 2022年世界卫生组织 (WHO) 对垂体神经内分泌瘤 (PitNET) 的分类强调转录因子 (TF) 进行诊断.
- 本研究评估了2022年世卫组织分类与2017年版本的非功能PitNET (NF-PitNET) 的临床实用性.
研究的目的:
- 评估2022年世卫组织分类对NF-PitNET亚型的临床实用性.
- 将2022年世卫组织分类与2017年分类的预后值进行比较.
- 确定NF-PitNET患者残留或复发疾病的预测因素.
主要方法:
- 分析了一组113名NF-PitNET患者的队列,这些患者在2010-2021年期间接受了治疗.
- 手术样本被染色为类固醇原因子 (SF-1),T-box家族成员TBX19 (TPIT) 和POU类1同源盒1 (Pit-1) 转录因子.
- 使用后勤和考克斯回归分析来评估NF-PitNET亚型与瘤相关结果之间的关联.
主要成果:
- 2022年世界卫生组织分类确定了SF-1血统 (58.4%),TPIT血统 (18.6%),没有明显的血统 (16.8%),以及Pit-1血统 (6.2%) 的NF-PitNET亚型.
- 在这些亚型中观察到无病生存率的显著差异 (p=0.003).
- 没有明显的血统和瘤体积的PitNET是残留或复发性疾病的独立预测因素.
结论:
- 2022年世卫组织分类提供了一个临床上有用的,基于TF的系统,用于分类NF-PitNET.
- 这种分类有助于区分NF-PitNET与不同的瘤行为和预后.
- 新的分类改善了非功能性垂体瘤的风险分层.
相关概念视频
01:17The Pituitary Gland
The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.
01:26Cushing Syndrome I: Introduction
Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...
01:19Cushing Syndrome II: Pathophysiology
Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...