■2022年世界卫生组织(WHO)对垂体神经内分泌肿瘤(PitNET)的分类在2017年取代了先前的分类,并进一步巩固了转录因子(TF)在PitNET诊断中的作用。这里,我们调查了2022年WHO分类的临床实用性,与2017年相比,在无功能的PitNET(NF-PitNET)患者队列中。
■共有113名NF-PitNET患者在2010年至2021年之间接受了切除术,并在玛丽医院进行了随访,香港,被招募。手术标本对三种TF进行重新染色:类固醇生成因子(SF-1),T-box家族成员TBX19(TPIT)和POU类1homeobox1(Pit-1)。通过逻辑和Cox回归分析评估了不同NF-PitNET亚型与肿瘤相关结局的关联。
■基于2022年WHO分类,大多数NF-PitNET是SF-1谱系肿瘤(58.4%),其次是TPIT谱系肿瘤(18.6%),无明显谱系肿瘤(16.8%)和Pit-1谱系肿瘤(6.2%)。尽管实体少于2017年分类,这四种亚型之间的无病生存率存在显着差异(对数秩检验p=0.003),特别是在SF-1谱系PitNET和PitNET之间,没有明显的谱系(对数秩检验p<0.001)。在多变量Cox回归分析中,PitNET亚型无明显谱系(HR3.02,95%CI1.28-7.16,p=0.012),与肿瘤体积(HR1.04,95%CI1.01-1.07,p=0.017),是残留或复发疾病复合的独立预测因子。
■2022年WHOPitNET分类是一种临床有用的TF和基于谱系的系统,用于对具有不同肿瘤行为和预后的NF-PitNET进行亚型分型。
UNASSIGNED: The 2022 World Health Organization (WHO) classification of pituitary neuroendocrine tumour (PitNET) supersedes the previous one in 2017 and further consolidates the role of transcription factors (TF) in the diagnosis of PitNET. Here, we investigated the clinical utility of the 2022 WHO classification, as compared to that of 2017, in a cohort of patients with non-functioning PitNET (NF-PitNET).
UNASSIGNED: A total of 113 NF-PitNET patients who underwent resection between 2010 and 2021, and had follow-up at Queen Mary Hospital, Hong Kong, were recruited. Surgical specimens were re-stained for the three TF: steroidogenic factor (SF-1), T-box family member TBX19 (TPIT) and POU class 1 homeobox 1 (Pit-1). The associations of different NF-PitNET subtypes with tumour-related outcomes were evaluated by logistic and Cox regression analyses.
UNASSIGNED: Based on the 2022 WHO classification, the majority of NF-PitNET was SF-1-lineage tumours (58.4%), followed by TPIT-lineage tumours (18.6%), tumours with no distinct lineage (16.8%) and Pit-1-lineage tumours (6.2%). Despite fewer entities than the 2017 classification, significant differences in disease-free survival were present amongst these four subtypes (Log-rank test p=0.003), specifically between SF-1-lineage PitNET and PitNET without distinct lineage (Log-rank test p<0.001). In multivariable Cox regression analysis, the subtype of PitNET without distinct lineage (HR 3.02, 95% CI 1.28-7.16, p=0.012), together with tumour volume (HR 1.04, 95% CI 1.01-1.07, p=0.017), were independent predictors of a composite of residual or recurrent disease.
UNASSIGNED: The 2022 WHO classification of PitNET is a clinically useful TF and lineage-based system for subtyping NF-PitNET with different tumour behaviour and prognosis.