1. Co-expression of multiple transcription factors is associated with clinical features and endocrine prognosis in growth hormone-secreting pituitary adenomas.
- Author
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Zhang Y, Tang H, Li S, Bie Z, Ma X, Wu H, Liu G, Wang X, Liu P, and Yang Z
- Subjects
- Humans, Male, Female, Middle Aged, Adult, Prognosis, Transcription Factor Pit-1 metabolism, Transcription Factor Pit-1 genetics, Human Growth Hormone metabolism, Human Growth Hormone blood, Aged, Young Adult, Insulin-Like Growth Factor I metabolism, Growth Hormone-Secreting Pituitary Adenoma metabolism, Growth Hormone-Secreting Pituitary Adenoma pathology, Growth Hormone-Secreting Pituitary Adenoma surgery, Adenoma metabolism, Adenoma surgery, Adenoma pathology, Transcription Factors metabolism, Transcription Factors genetics
- Abstract
Background: The types of growth hormone-secreting pituitary adenomas are diverse, we have found that there are significant differences in clinical features and prognosis between PIT-1 single-cell spectrum growth hormone adenomas and growth hormone phenotypic polyhormonal adenomas., Methods: This study examined a cohort of 193 patients with growth hormone-secreting pituitary adenoma (GHPA), stratifying them into two groups: PIT-1 single transcription factor positive growth hormone adenoma (STF-GHPA) and Multiple transcription factor-positive growth hormone-secreting adenomas (MTF-GHPA). The objective was to compare these two groups' clinical characteristics. Within the MTF-GHPA group, we further subtyped them based on transcription factors to evaluate potential variations in clinical manifestations. Logistic regression analyses were employed to develop a risk factor model for investigating factors influencing hormone remission., Results: There were no statistically significant differences in terms of age, gender, serum GH, and IGF-1 levels between patients diagnosed with MTF-GHPA and STF-GHPA. However, patients with MTF-GHPA exhibited a higher proportion of hypopituitarism compared to those with STF-GHPA. Furthermore, MTF-GHPA were characterized by smaller tumor size and less invasiveness, as indicated by lower Knosp classes. However, patients with MTF-GHPA have a lower rate of hormonal remission (30.8%) and more postoperative complications (31.0%), which means that STF-GHPA (hormonal remission:71.6%; postoperative complications:13.4%) has a better endocrine outcome than MTF-GHPA patients. Between the PIT-1 + SF-1+ and PIT-1 + TPIT+ subtypes within MTF-GHPA, significant differences were also observed in tumor size, endocrine outcomes, and postoperative complications. Risk factors influencing hormonal remission for GHPA included preoperative GH level, primary/recurrent, extent of resection, and transcription factor expression., Conclusion: Co-expression of multiple transcription factors is an important factor associated with clinical behavior and endocrine outcomes in patients with GHPA., Competing Interests: Compliance with ethical standards. Conflict of interest: The authors declare no competing interests. Ethical approval: This study was approved by the ethics committee of Beijing Tiantan Hospital, Capital Medical University (KY2022-209-02). Informed consent was obtained from all individual participants included in the study. This study was performed in line with the principles of the Declaration of Helsinki., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2025
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