ASSESSMENT AND COMPARISON OF HORMONAL IMMUNOEXPRESSION AND THE CLINICAL PICTURE IN PATIENTS WITH PITUITARY ADENOMAS

Acta Endocrinol (Buchar). 2020 Apr-Jun;16(2):148-155. doi: 10.4183/aeb.2020.148.

Abstract

Introduction: Symptoms related to hypersecretion of hormones in patients with pituitary adenomas do not always correlate with immunohistochemical staining results.

Objective: To evaluate the relationship between the pituitary adenomas hormone immunoexpressions and endocrine presentations.

Patients and methods: The clinical status and immunoexpression of 72 patients who underwent transsphenoidal surgery for pituitary adenomas were analyzed.

Results: Macroadenomas were diagnosed in 51 cases (70.84%), while microadenomas were found in 21 cases (29.16%). The 72 adenoma specimens were divided into 22 monohormonal, 21 plurihormonal, 21 immunonegative and 8 unreliable specimens. The positive immunohistochemical staining results occurred as follows: prolactin and growth hormone 25% each, adrenocorticotropic hormone 13.89%, thyroid-stimulating hormone 5.56%, leuteinizing hormone and follicle-stimulating hormone 12.5%, glycoprotein hormone alpha-subunit 22.22%. Statistically significant relationships between the immunohistochemical presentation and the preoperative diagnosis were found for prolactin and hyperprolactinemia, growth hormone and acromegaly and adrenocorticotropic hormone and Cushing's syndrome.

Conclusions: The lack of full concordance between the clinical presentations and immunohistochemical staining was mainly a result of the presence of nonfunctioning adenomas, plurihormonal adenomas and unreliable specimens. The morphometric method introduced in this study, utilizing the immunoexpression index, provided a very precise evaluation of pituitary adenomas pathology.

Keywords: adenoma symptomse; hormonal immunoexpression; pituitary adenoma; transsphenoidal surgery.