Clinical characteristics and prognostic analysis of multilinage pituitary neuroendocrine tumors
Objective To investigate the clinical characteristics and prognostic features of multilineage pituitary neuroendocrine tumors(PitNETs).Methods A retrospective analysis was conducted on the clinical data of 369 patients with PitNETs who underwent surgical treatment at the Neurosurgery Center of Beijing Tiantan Hospital,Capital Medical University from January 2019 to October 2021.The patients were divided into multilineage PitNETs(i.e.,those with positive expression of at least 2 pituitary transcription factors)and three monolineage PitNETs(including PIT1,SF1 and TPIT lineages)based on the postoperative pathological results.The clinical features and outcomes of multilineage PitNETs patients were summarized,and comparisons were made with those of the three monolineage patients.Results Compared with the SF1 lineage,patients with multilineage PitNETs had a higher invasive tendency[proportion of Knosp grade 3-4:48.3％(42/87)vs.31.5％(28/89),P=0.023].Compared with the TPIT lineage,the maximum diameter of their tumors was smaller(25.4±11.4 mm vs.30.2±13.4 mm,P=0.014).Compared with SF1 lineage[3.4％(3/89)]and TPIT lineage PitNETs patients[16.5％(13/79)],multilineage PitNETs patients[31.0％(27/87)]showed more obvious symptoms of hormone oversecretion(both P＜0.05).During a median follow-up period of 27 months,patients with multiple lineage PitNETs[71.2％(47/66)]had a higher clinical symptom improvement rate than those with PIT1 lineage[37.5％(36/96)]and SF1 lineage[44.8％(26/58)](both P＜0.05),and were more prone to pituitary dysfunction compared with patients with TPIT lineage[incidence rate:55.8％(29/52)vs.26.8％(11/41),P=0.005].Conclusion The clinical attributes and prognosis associated with multilineage PitNETs diverge from those of any monolineage PitNETs,delineating a distinct subtype with unique clinical features.
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