User menu

Accès à distance ? S'identifier sur le proxy UCLouvain

A new prognostic clinicopathological classification of pituitary adenomas: a multicentric case-control study of 410 patients with 8 years post-operative follow-up.

Primary tabs

Trouillas, Jacqueline Roy, Pascal Sturm, Nathalie Dantony, Emmanuelle Cortet-Rudelli, Christine Delgrange, Etienne [UCL] Tabarin, A

Pituitary adenomas are currently classified by histological, immunocytochemical and numerous ultrastructural characteristics lacking unequivocal prognostic correlations. We investigated the prognostic value of a new clinicopathological classification with grades based on invasion and proliferation. This retrospective multicentric case-control study comprised 410 patients who had surgery for a pituitary tumour with long-term follow-up. Using pituitary magnetic resonance imaging for diagnosis of cavernous or sphenoid sinus invasion, immunocytochemistry, markers of the cell cycle (Ki-67, mitoses) and p53, tumours were classified according to size (micro, macro and giant), type (PRL, GH, FSH/LH, ACTH and TSH) and grade (grade 1a: non-invasive, 1b: non-invasive and proliferative, 2a: invasive, 2b: invasive and proliferative, and 3: metastatic). The association between patient status at 8-year follow-up and age, sex, and classification was evaluated by two multivariate analyses assessing disease- or recurrence/progression-free status. At 8 years after surgery, 195 patients were disease-free (controls) and 215 patients were not (cases). In 125 of the cases the tumours had recurred or progressed. Analyses of disease-free and recurrence/progression-free status revealed the significant prognostic value (p < 0.001; p < 0.05) of age, tumour type, and grade across all tumour types and for each tumour type. Invasive and proliferative tumours (grade 2b) had a poor prognosis with an increased probability of tumour persistence or progression of 25- or 12-fold, respectively, as compared to non-invasive tumours (grade 1a). This new, easy to use clinicopathological classification of pituitary endocrine tumours has demonstrated its prognostic worth by strongly predicting the probability of post-operative complete remission or tumour progression and so could help clinicians choose the best post-operative therapy.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2013
Language Anglais
Journal information "Acta Neuropathologica" - Vol. 126, no.1, p. 123-135 (2013)
Peer reviewed yes
Publisher Springer ((Germany) Heidelberg)
issn 0001-6322
e-issn 1432-0533
Publication status Publié
Affiliations UCL - (MGD) Service de médecine interne générale - endocrinologie
UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition
MESH Subject Adolescent ; Adult ; Age Factors ; Aged ; Case-Control Studies ; Disease-Free Survival ; Female ; Humans ; Longitudinal Studies ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pituitary Gland ; Pituitary Neoplasms ; Prognosis ; Recurrence ; Retrospective Studies ; Sensitivity and Specificity ; Sex Factors ; Young Adult
Keywords Classification ; Pituitary tumour ; Pituitary adenoma
Links
  1. Amar Arun Paul, Hinton David R., Krieger Mark D., Weiss Martin H., 10.1023/a:1009931413106
  2. Asa SL (2011) Tumors of the Pituitary Gland AFIP Fascicle 15/4. 1st edn. p 275. ISBN: 9781933477152
  3. Barker Fred G., Klibanski Anne, Swearingen Brooke, Transsphenoidal Surgery for Pituitary Tumors in the United States, 1996–2000: Mortality, Morbidity, and the Effects of Hospital and Surgeon Volume, 10.1210/jc.2003-030461
  4. Breslow NE, Day NE (1980) Statistical methods in cancer research. In: The analysis of case-control studies, vol I, issue number 32. IARC Sci Publ, Lyon, pp 5–338
  5. Cornelius Aurélie, Cortet-Rudelli Christine, Assaker Richard, Kerdraon Olivier, Gevaert Marie-Hélène, Prévot Vincent, Lassalle Philippe, Trouillas Jacqueline, Delehedde Maryse, Maurage Claude-Alain, Endothelial Expression of Endocan Is Strongly Associated with Tumor Progression in Pituitary Adenoma : Endocan in Pituitary Adenoma, 10.1111/j.1750-3639.2012.00578.x
  6. Cottier Jean-Philippe, Destrieux Christophe, Brunereau Laurent, Bertrand Philippe, Moreau Laurence, Jan Michel, Herbreteau Denis, Cavernous Sinus Invasion by Pituitary Adenoma: MR Imaging, 10.1148/radiology.215.2.r00ap18463
  7. Daly Adrian F., Rixhon Martine, Adam Christelle, Dempegioti Anastasia, Tichomirowa Maria A., Beckers Albert, High Prevalence of Pituitary Adenomas: A Cross-Sectional Study in the Province of Liège, Belgium, 10.1210/jc.2006-1668
  8. Delgrange E., Sex-Related Difference in the Growth of Prolactinomas: A Clinical and Proliferation Marker Study, 10.1210/jc.82.7.2102
  9. Dubois S., Guyetant S., Menei P., Rodien P., Illouz F., Vielle B., Rohmer V., Relevance of Ki-67 and prognostic factors for recurrence/progression of gonadotropic adenomas after first surgery, 10.1530/eje-07-0099
  10. Fernandez Alberto, Karavitaki Niki, Wass John A. H., Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK), 10.1111/j.1365-2265.2009.03667.x
  11. Figarella-Branger Dominique, Trouillas Jacqueline, The new WHO classification of human pituitary tumors: comments, 10.1007/s00401-005-1099-0
  12. François Patrick, Travers Nadine, Lescanne Emmanuel, Arbeille Brigitte, Jan Michel, Velut Stéphane, The interperiosteo-dural concept applied to the perisellar compartment: a microanatomical and electron microscopic study : Laboratory investigation, 10.3171/2010.1.jns081701
  13. Fusco A., Zatelli M. C., Bianchi A., Cimino V., Tilaro L., Veltri F., Angelini F., Lauriola L., Vellone V., Doglietto F., Ambrosio M. R., Maira G., Giustina A., degli Uberti E. C., Pontecorvi A., De Marinis L., Prognostic Significance of the Ki-67 Labeling Index in Growth Hormone-Secreting Pituitary Adenomas, 10.1210/jc.2008-0126
  14. Galland F., Lacroix L., Saulnier P., Dessen P., Meduri G., Bernier M., Gaillard S., Guibourdenche J., Fournier T., Evain-Brion D., Bidart J. M., Chanson P., Differential gene expression profiles of invasive and non-invasive non-functioning pituitary adenomas based on microarray analysis, 10.1677/erc-10-0018
  15. Gejman Roger, Swearingen Brooke, Hedley-Whyte E. Tessa, Role of Ki-67 proliferation index and p53 expression in predicting progression of pituitary adenomas, 10.1016/j.humpath.2007.10.004
  16. Grossman Ashley B., The 2004 World health organization classification of pituitary tumors: is it clinically helpful?, 10.1007/s00401-005-1101-x
  17. Heaney Anthony P., Pituitary Carcinoma: Difficult Diagnosis and Treatment, 10.1210/jc.2011-2031
  18. Honegger Jürgen, Prettin Carsten, Feuerhake Friedrich, Petrick Manfred, Schulte-Mönting Jürgen, Reincke Martin, Expression of Ki-67 antigen in nonfunctioning pituitary adenomas: correlation with growth velocity and invasiveness, 10.3171/jns.2003.99.4.0674
  19. Horvath E., Kovacs K., Smyth H. S., Cusimano M., Singer W., Silent Adenoma Subtype 3 of the Pituitary—Immunohistochemical and Ultrastructural Classification: A Review of 29 Cases, 10.1080/01913120500323514
  20. Jaffrain-Rea M., A critical reappraisal of MIB-1 labelling index significance in a large series of pituitary tumours: secreting versus non-secreting adenomas, 10.1677/erc.0.0090103
  21. Kaltsas Gregory A., Nomikos Panagiotis, Kontogeorgos George, Buchfelder Michael, Grossman Ashley B., Diagnosis and Management of Pituitary Carcinomas, 10.1210/jc.2004-2231
  22. Knosp Engelbert, Kitz Klaus, Perneczky Axel, Proliferation Activity in Pituitary Adenomas: Measurement by Monoclonal Antibody Ki-67 : , 10.1227/00006123-198912000-00012
  23. Knosp Engelbert, Steiner Erich, Kitz Klaus, Matula Christian, Pituitary Adenomas with Invasion of the Cavernous Sinus Space : A Magnetic Resonance Imaging Classification Compared with Surgical Findings, 10.1227/00006123-199310000-00008
  24. Kovacs K, Horvath E, Ezrin C (1977) Pituitary adenomas. Pathol Annu 12(Pt 2):341–382
  25. Kovacs Kalman, Scheithauer Bernd W., Horvath Eva, Lloyd Ricardo V., The world health organization classification of adenohypophysial neoplasms: A proposed five-tier scheme, 10.1002/(sici)1097-0142(19960801)78:3<502::aid-cncr18>3.0.co;2-2
  26. Laws Edward R., Lopes M. Beatriz S., The new WHO classification of pituitary tumors: highlights and areas of controversy, 10.1007/s00401-005-1103-8
  27. Lloyd RV, Kovacs K, Young Jr WF, Farrel WE, Asa SL, Trouillas J, Kontogeorgos G, Sano T, Scheithauer B, Horvath E (2004) Pituitary tumours : introduction. In: DeLellis RA, Lloyd RV, Heitz PU, Eng C (eds) Tumours of the pituitary, chapter 1. Pathology and genetics of tumours of endocrine organs. World Hearth Organization Classification of Tumours. IARC Press, Lyon, pp 10–13
  28. Losa Marco, Mortini Pietro, Barzaghi Raffaella, Ribotto Paolo, Terreni Maria Rosa, Marzoli Stefania Bianchi, Pieralli Sandra, Giovanelli Massimo, Early results of surgery in patients with nonfunctioning pituitary adenoma and analysis of the risk of tumor recurrence, 10.3171/jns/2008/108/3/0525
  29. Madsen Helen, Borges Thomas M., Knox Aaron J., Michaelis Katherine A., Xu Mei, Lillehei Kevin O., Wierman Margaret E., Kleinschmidt-DeMasters Bette Kay, Giant Pituitary Adenomas : Pathologic-Radiographic Correlations and Lack of Role for p53 and MIB-1 Labeling, 10.1097/pas.0b013e31821e8c96
  30. McCormack Ann I., Wass John A. H., Grossman Ashley B., Aggressive pituitary tumours: the role of temozolomide and the assessment of MGMT status : AGGRESSIVE PITUITARY TUMOURS, 10.1111/j.1365-2362.2011.02520.x
  31. Meij Björn P., Lopes Maria-Beatriz S., Ellegala Dilantha B., Alden Tord D., Laws Edward R., The long-term significance of microscopic dural invasion in 354 patients with pituitary adenomas treated with transsphenoidal surgery, 10.3171/jns.2002.96.2.0195
  32. Nose V, Ezzat S, Horvath E, Kovacs K, Laws ER, Lloyd R, Lopes MB, Asa SL (2011) Protocol for the examination of specimens from patients with primary pituitary tumors. Arch Pathol Lab Med 135(5):640–646
  33. Obari Abdulkader, Sano Toshiaki, Ohyama Kenichi, Kudo Eiji, Qian Zhi Rong, Yoneda Akiko, Rayhan Nasim, Mustafizur Rahman Muhammad, Yamada Shozo, Clinicopathological Features of Growth Hormone-producing Pituitary Adenomas: Difference among Various Types Defined by Cytokeratin Distribution Pattern Including a Transitional Form, 10.1007/s12022-008-9029-z
  34. Pack Svetlana D., Qin Liu-Xiu, Pak Evgenia, Wang Yun, Ault David O., Mannan Poonam, Jaikumar Sivakumar, Stratakis Constantine A., Oldfield Edward H., Zhuang Zhengping, Weil Robert J., Common genetic changes in hereditary and sporadic pituitary adenomas detected by comparative genomic hybridization, 10.1002/gcc.20162
  35. R Development Core Team (2009) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0. http://www.R-project.org
  36. Ramírez Claudia, Cheng Sonia, Vargas Guadalupe, Asa Sylvia L., Ezzat Shereen, González Baldomero, Cabrera Lourdes, Guinto Gerardo, Mercado Moisés, Expression of Ki-67, PTTG1, FGFR4, and SSTR 2, 3, and 5 in Nonfunctioning Pituitary Adenomas: A High Throughput TMA, Immunohistochemical Study, 10.1210/jc.2011-3163
  37. Raverot Gérald, Castinetti Frédéric, Jouanneau Emmanuel, Morange Isabelle, Figarella-Branger Dominique, Dufour Henry, Trouillas Jacqueline, Brue Thierry, Pituitary carcinomas and aggressive pituitary tumours: merits and pitfalls of temozolomide treatment, 10.1111/j.1365-2265.2012.04381.x
  38. Raverot Gérald, Sturm Nathalie, de Fraipont Florence, Muller Marie, Salenave Sylvie, Caron Philippe, Chabre Olivier, Chanson Philippe, Cortet-Rudelli Christine, Assaker Richard, Dufour Henry, Gaillard Stephan, François Patrick, Jouanneau Emmanuel, Passagia Jean-Guy, Bernier Michèle, Cornélius Aurélie, Figarella-Branger Dominique, Trouillas Jacqueline, Borson-Chazot Françoise, Brue Thierry, Temozolomide Treatment in Aggressive Pituitary Tumors and Pituitary Carcinomas: A French Multicenter Experience, 10.1210/jc.2010-0644
  39. Raverot Gérald, Wierinckx Anne, Dantony Emmanuelle, Auger Carole, Chapas Guillaume, Villeneuve Laurent, Brue Thierry, Figarella-Branger Dominique, Roy Pascal, Jouanneau Emmanuel, Jan Michel, Lachuer Joël, Trouillas Jacqueline, Prognostic Factors in Prolactin Pituitary Tumors: Clinical, Histological, and Molecular Data from a Series of 94 Patients with a Long Postoperative Follow-Up, 10.1210/jc.2009-1191
  40. Raverot G., Wierinckx A., Jouanneau E., Auger C., Borson-Chazot F., Lachuer J., Pugeat M., Trouillas J., Clinical, hormonal and molecular characterization of pituitary ACTH adenomas without (silent corticotroph adenomas) and with Cushing's disease, 10.1530/eje-10-0076
  41. Rickert Christian H., Dockhorn-Dworniczak Barbara, Busch Günter, Maskopp Dag, Albert Friedrich K., Rama Burckhard, Paulus Werner, Increased chromosomal imbalances in recurrent pituitary adenomas, 10.1007/s004010100413
  42. Rickert CH, Scheithauer BW, Paulus W (2001) Chromosomal aberrations in pituitary carcinoma metastases. Acta Neuropathol 102(2):117–120
  43. Righi Alberto, Agati Patrizia, Sisto Andrea, Frank Giorgio, Faustini-Fustini Marco, Agati Raffaele, Mazzatenta Diego, Farnedi Anna, Menetti Federico, Marucci Gianluca, Foschini Maria P., A classification tree approach for pituitary adenomas, 10.1016/j.humpath.2011.12.003
  44. Rindi G., , Klöppel G., Alhman H., Caplin M., Couvelard A., de Herder W. W., Erikssson B., Falchetti A., Falconi M., Komminoth P., Körner M., Lopes J. M., McNicol A-M., Nilsson O., Perren A., Scarpa A., Scoazec J-Y., Wiedenmann B., TNM staging of foregut (neuro)endocrine tumors: a consensus proposal including a grading system, 10.1007/s00428-006-0250-1
  45. Roelfsema Ferdinand, Biermasz Nienke R., Pereira Alberto M., Clinical factors involved in the recurrence of pituitary adenomas after surgical remission: a structured review and meta-analysis, 10.1007/s11102-011-0347-7
  46. Saeger W., Lüdecke B., Lüdecke D., Clinical Tumor Growth and Comparison with Proliferation Markers in Non-functioning (Inactive) Pituitary Adenomas, 10.1055/s-2007-991131
  47. Saeger W., Ludecke D. K, Buchfelder M., Fahlbusch R., Quabbe H.-J., Petersenn S., Pathohistological classification of pituitary tumors: 10 years of experience with the German Pituitary Tumor Registry, 10.1530/eje.1.02326
  48. Salehi Fateme, Agur Anne, Scheithauer Bernd W., Kovacs Kalman, Lloyd Ricardo V., Cusimano Michael, Ki-67 In Pituitary Neoplasms: A Review—Part I, 10.1227/01.neu.0000349930.66434.82
  49. Scheithauer Bernd W., Kovacs Kalman T., Laws Edward R., Randall Raymond V., Pathology of invasive pituitary tumors with special reference to functional classification, 10.3171/jns.1986.65.6.0733
  50. Scheithauer BW, Kurtkaya-Yapicier O, Kovacs KT, Young WF Jr, Lloyd RV (2005) Pituitary carcinoma: a clinicopathological review. Neurosurgery 56(5):1066–1074
  51. Solcia Enrico, Klöppel Günter, Sobin Leslie H., Histological Typing of Endocrine Tumours, ISBN:9783540661696, 10.1007/978-3-642-59655-1
  52. Thapar Kamal, Kovacs Kalman, Scheithauer Bernd W., Stefaneanu Lucia, Horvath Eva, Peter J. Pernicone, Murray David, Laws Edward R., Proliferative Activity and Invasiveness among Pituitary Adenomas and Carcinomas: An Analysis Using the MIB-1 Antibody, 10.1097/00006123-199601000-00024
  53. Thapar Kamal, Scheithauer Bernd W., Kovacs Kalman, Pernicone Peter J., Laws Edward R., p53 Expression in Pituitary Adenomas and Carcinomas: Correlation with Invasiveness and Tumor Growth Fractions, 10.1227/00006123-199604000-00027
  54. Trouillas J, Cure M, Lheritier M, Guichard Y, Girod C (1974) Essai de classification cytofonctionnelle de 19 adénomes hypophysaires d’après des données histologiques, immunocytochimiques, biométriques et ultrastructurales. Rev Oto-Neuro-Ophtalmol 47(3):223–236
  55. Trouillas Jacqueline, Daniel Laurent, Guigard Marie-Paule, Tong Soutsakhone, Gouvernet Joanny, Jouanneau Emmanuel, Jan Michel, Perrin Gilles, Fischer Georges, Tabarin Antoine, Rougon Geneviève, Figarella-Branger Dominique, Polysialylated neural cell adhesion molecules expressed in human pituitary tumors and related to extrasellar invasion, 10.3171/jns.2003.98.5.1084
  56. Trouillas J, Girod C (1996) Pathology of pituitary adenomas. In: Landolt AM, Vance ML, Reilly PL (eds) Pituitary adenomas. Churchill Livingstone, New York, pp 27–46
  57. Trouillas Jacqueline, Labat-Moleur Françoise, Sturm Nathalie, Kujas Michèle, Heymann Marie-Françoise, Figarella-Branger Dominique, Patey Martine, Mazucca Marc, Decullier Evelyne, Vergès Bruno, Chabre Olivier, Calender Alain, Pituitary Tumors and Hyperplasia in Multiple Endocrine Neoplasia Type 1 Syndrome (MEN1): A Case-Control Study in a Series of 77 Patients Versus 2509 Non-MEN1 Patients : , 10.1097/pas.0b013e31815ade45
  58. Wierinckx A., Auger C., Devauchelle P., Reynaud A., Chevallier P., Jan M., Perrin G., Fevre-Montange M., Rey C., Figarella-Branger D., Raverot G., Belin M.-F., Lachuer J., Trouillas J., A diagnostic marker set for invasion, proliferation, and aggressiveness of prolactin pituitary tumors, 10.1677/erc-07-0062
  59. Wierinckx Anne, Raverot Gérald, Nazaret Nicolas, Jouanneau Emmanuel, Auger Carole, Lachuer Joël, Trouillas Jacqueline, Proliferation markers of human pituitary tumors: Contribution of a genome-wide transcriptome approach, 10.1016/j.mce.2010.02.043
  60. Wierinckx A, Roche M, Raverot G, Legras-Lachuer C, Croze S, Nazaret N, Rey C, Auger C, Jouanneau E, Chanson P, Trouillas J, Lachuer J (2011) Integrated genomic profiling identifies loss of chromosome 11p impacting transcriptomic activity in aggressive pituitary PRL tumors. Brain Pathol 21(5):533–543
  61. Wolfsberger Stefan, Knosp Engelbert, Comments on the WHO 2004 classification of pituitary tumors, 10.1007/s00401-005-1097-2
  62. Zada Gabriel, Woodmansee Whitney W., Ramkissoon Shakti, Amadio Jordan, Nose Vania, Laws Edward R., Atypical pituitary adenomas: incidence, clinical characteristics, and implications : Clinical article, 10.3171/2010.8.jns10290
  63. Zhang X., Pituitary Tumor Transforming Gene (PTTG) Expression in Pituitary Adenomas, 10.1210/jc.84.2.761
Bibliographic reference Trouillas, Jacqueline ; Roy, Pascal ; Sturm, Nathalie ; Dantony, Emmanuelle ; Cortet-Rudelli, Christine ; et. al. A new prognostic clinicopathological classification of pituitary adenomas: a multicentric case-control study of 410 patients with 8 years post-operative follow-up.. In: Acta Neuropathologica, Vol. 126, no.1, p. 123-135 (2013)
Permanent URL http://hdl.handle.net/2078.1/134692