Comparison of the clinical and prognostic characteristics of patients with different pathological types in acromegaly

ContextAcromegaly is caused by somatotroph tumors. Recently, the WHO recommended the use of transcription factors (TFs) together with pituitary hormones to accurately classify the subtypes.ObjectiveThis study aims to evaluate differences in the clinical and prognostic characteristics of acromegaly p...

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Main Authors: Liye Chong, Yuxing Lou, Xue Chen, Wenji Zhao, Wei Zhang, Ziwei Zhang, Fan Yang, Ping Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1571598/full
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author Liye Chong
Liye Chong
Yuxing Lou
Yuxing Lou
Xue Chen
Wenji Zhao
Wenji Zhao
Wei Zhang
Wei Zhang
Ziwei Zhang
Ziwei Zhang
Fan Yang
Fan Yang
Ping Li
Ping Li
Ping Li
author_facet Liye Chong
Liye Chong
Yuxing Lou
Yuxing Lou
Xue Chen
Wenji Zhao
Wenji Zhao
Wei Zhang
Wei Zhang
Ziwei Zhang
Ziwei Zhang
Fan Yang
Fan Yang
Ping Li
Ping Li
Ping Li
author_sort Liye Chong
collection DOAJ
description ContextAcromegaly is caused by somatotroph tumors. Recently, the WHO recommended the use of transcription factors (TFs) together with pituitary hormones to accurately classify the subtypes.ObjectiveThis study aims to evaluate differences in the clinical and prognostic characteristics of acromegaly patients with different pathological types.MethodsA retrospective study was conducted on 94 acromegaly patients who underwent surgical treatment. Patients were classified into two groups on the basis of TFs expression by IHC. PIT1 tumors were positive only for PIT1, and PIT1/SF1 tumors were positive for both PIT1 and SF1. Additionally, on the basis of the expression of GH and PRL by IHC, PIT1 tumors were further subdivided into GH positive tumors (those positive for only GH) and GH/PRL positive tumors (those positive for both GH and PRL). Differences in clinical and prognostic features among the pathological groups were evaluated.ResultsPIT1/SF1 tumors represented 30.9% (n = 29) of the acromegaly patients in this cohort. PIT1/SF1 tumors had a higher baseline IGF-1 index (2.77 ± 0.73 vs. 2.39 ± 0.74, P = 0.024) than PIT1 tumors. Despite the higher proportion of postoperative GH < 1 μg/L, the biochemical remission rate of PIT1/SF1 tumors (30.8% vs. 27.6%, P = 0.812) was similar to that of PIT1 tumors. Compared with those with GH positive tumors, patients with GH/PRL positive tumors were younger at diagnosis (42.50 ± 13.36 vs. 49.05 ± 11.69, P = 0.046), and the proportion of male patients was higher (50.0% vs. 23.3%, P = 0.048). Furthermore, patients with GH/PRL positive tumors had a significantly higher postoperative GH level [7.30 (3.18–11.08) vs. 2.49 (1.57–6.84), P = 0.011] and IGF-1 index (1.82 ± 0.94 vs. 1.31 ± 0.63, P = 0.011) during follow-up. The biochemical remission rate in GH/PRL positive tumors was lower, but the difference was not statistically significant (18.2% vs. 37.2%, P = 0.159).ConclusionPIT1/SF1 tumors represent approximately 30.0% of acromegaly patients. Despite higher baseline IGF-1 levels, the clinical and prognostic features of patients with PIT1/SF1 tumors are similar to those of patients with PIT1 tumors. GH/PRL positive tumors, characterized by their earlier age at diagnosis and male predominance, tend to exhibit a lower biochemical remission rate compared to GH positive tumors.
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spelling doaj-art-1cf9d19ec3794ea790f18e86abf117d12025-08-20T03:09:38ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-05-011610.3389/fendo.2025.15715981571598Comparison of the clinical and prognostic characteristics of patients with different pathological types in acromegalyLiye Chong0Liye Chong1Yuxing Lou2Yuxing Lou3Xue Chen4Wenji Zhao5Wenji Zhao6Wei Zhang7Wei Zhang8Ziwei Zhang9Ziwei Zhang10Fan Yang11Fan Yang12Ping Li13Ping Li14Ping Li15Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaNanjing Drum Tower Hospital, Branch of National Clinical Research Center for Metabolic Diseases, Nanjing, ChinaDepartment of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, ChinaNanjing Drum Tower Hospital, Branch of National Clinical Research Center for Metabolic Diseases, Nanjing, ChinaDepartment of Pathology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, ChinaDepartment of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaNanjing Drum Tower Hospital, Branch of National Clinical Research Center for Metabolic Diseases, Nanjing, ChinaDepartment of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaNanjing Drum Tower Hospital, Branch of National Clinical Research Center for Metabolic Diseases, Nanjing, ChinaDepartment of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaNanjing Drum Tower Hospital, Branch of National Clinical Research Center for Metabolic Diseases, Nanjing, ChinaDepartment of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaNanjing Drum Tower Hospital, Branch of National Clinical Research Center for Metabolic Diseases, Nanjing, ChinaDepartment of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, ChinaNanjing Drum Tower Hospital, Branch of National Clinical Research Center for Metabolic Diseases, Nanjing, ChinaContextAcromegaly is caused by somatotroph tumors. Recently, the WHO recommended the use of transcription factors (TFs) together with pituitary hormones to accurately classify the subtypes.ObjectiveThis study aims to evaluate differences in the clinical and prognostic characteristics of acromegaly patients with different pathological types.MethodsA retrospective study was conducted on 94 acromegaly patients who underwent surgical treatment. Patients were classified into two groups on the basis of TFs expression by IHC. PIT1 tumors were positive only for PIT1, and PIT1/SF1 tumors were positive for both PIT1 and SF1. Additionally, on the basis of the expression of GH and PRL by IHC, PIT1 tumors were further subdivided into GH positive tumors (those positive for only GH) and GH/PRL positive tumors (those positive for both GH and PRL). Differences in clinical and prognostic features among the pathological groups were evaluated.ResultsPIT1/SF1 tumors represented 30.9% (n = 29) of the acromegaly patients in this cohort. PIT1/SF1 tumors had a higher baseline IGF-1 index (2.77 ± 0.73 vs. 2.39 ± 0.74, P = 0.024) than PIT1 tumors. Despite the higher proportion of postoperative GH < 1 μg/L, the biochemical remission rate of PIT1/SF1 tumors (30.8% vs. 27.6%, P = 0.812) was similar to that of PIT1 tumors. Compared with those with GH positive tumors, patients with GH/PRL positive tumors were younger at diagnosis (42.50 ± 13.36 vs. 49.05 ± 11.69, P = 0.046), and the proportion of male patients was higher (50.0% vs. 23.3%, P = 0.048). Furthermore, patients with GH/PRL positive tumors had a significantly higher postoperative GH level [7.30 (3.18–11.08) vs. 2.49 (1.57–6.84), P = 0.011] and IGF-1 index (1.82 ± 0.94 vs. 1.31 ± 0.63, P = 0.011) during follow-up. The biochemical remission rate in GH/PRL positive tumors was lower, but the difference was not statistically significant (18.2% vs. 37.2%, P = 0.159).ConclusionPIT1/SF1 tumors represent approximately 30.0% of acromegaly patients. Despite higher baseline IGF-1 levels, the clinical and prognostic features of patients with PIT1/SF1 tumors are similar to those of patients with PIT1 tumors. GH/PRL positive tumors, characterized by their earlier age at diagnosis and male predominance, tend to exhibit a lower biochemical remission rate compared to GH positive tumors.https://www.frontiersin.org/articles/10.3389/fendo.2025.1571598/fullacromegalyPIT1/SF1 tumorGH/PRL positive tumorclinical characteristicsprognosis
spellingShingle Liye Chong
Liye Chong
Yuxing Lou
Yuxing Lou
Xue Chen
Wenji Zhao
Wenji Zhao
Wei Zhang
Wei Zhang
Ziwei Zhang
Ziwei Zhang
Fan Yang
Fan Yang
Ping Li
Ping Li
Ping Li
Comparison of the clinical and prognostic characteristics of patients with different pathological types in acromegaly
Frontiers in Endocrinology
acromegaly
PIT1/SF1 tumor
GH/PRL positive tumor
clinical characteristics
prognosis
title Comparison of the clinical and prognostic characteristics of patients with different pathological types in acromegaly
title_full Comparison of the clinical and prognostic characteristics of patients with different pathological types in acromegaly
title_fullStr Comparison of the clinical and prognostic characteristics of patients with different pathological types in acromegaly
title_full_unstemmed Comparison of the clinical and prognostic characteristics of patients with different pathological types in acromegaly
title_short Comparison of the clinical and prognostic characteristics of patients with different pathological types in acromegaly
title_sort comparison of the clinical and prognostic characteristics of patients with different pathological types in acromegaly
topic acromegaly
PIT1/SF1 tumor
GH/PRL positive tumor
clinical characteristics
prognosis
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1571598/full
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