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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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Endocrinology |
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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. |
| format | Article |
| id | doaj-art-1cf9d19ec3794ea790f18e86abf117d1 |
| institution | DOAJ |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| 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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