Advancements in Molecular Diagnosis and Pharmacotherapeutic Strategies for Invasive Pituitary Adenomas
ABSTRACT Background The overwhelming majority of pituitary tumors consist of pituitary adenomas (PAs), which have recently also been termed pituitary neuroendocrine tumors (PitNETs). Clinically significant PAs occur in approximately one in every 1000 individuals, while other types of pituitary tumor...
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Wiley
2024-12-01
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| Series: | Immunity, Inflammation and Disease |
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| Online Access: | https://doi.org/10.1002/iid3.70098 |
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| author | Dingkai Xu Ling Wang Maohua Zheng |
| author_facet | Dingkai Xu Ling Wang Maohua Zheng |
| author_sort | Dingkai Xu |
| collection | DOAJ |
| description | ABSTRACT Background The overwhelming majority of pituitary tumors consist of pituitary adenomas (PAs), which have recently also been termed pituitary neuroendocrine tumors (PitNETs). Clinically significant PAs occur in approximately one in every 1000 individuals, while other types of pituitary tumors, such as craniopharyngiomas and pituicytomas, are significantly less common. Although PAs are generally benign, a subset of them exhibits malignant‐like biological traits. They tend to infiltrate and grow aggressively into adjacent tissues and organs, including the dura mater, cavernous sinus, and sphenoid sinus. This invasive behavior often results in the destruction of the normal anatomical architecture of the sella turcica and skull base. Clinically, such tumors are classified as invasive PAs (IPAs), emphasizing their aggressive and destructive nature. Objective and Significance Currently, the diagnostic indicators for IPAs frequently suffer from suboptimal sensitivity and specificity. The invasiveness assessment of PAs lacks a definitive gold standard and instead serves as a predictive tool, with a greater number of indicators met suggesting a higher likelihood of invasiveness. Consequently, a comprehensive approach that integrates imaging, pathological, molecular biological, and other disciplinary metrics is crucial for accurate evaluation. Despite surgery being the primary treatment modality for IPAs, their malignant‐like behavior complicates complete resection, resulting in lower resection rates and heightened postoperative recurrence, necessitating multiple surgeries. Therefore, adjunctive drug therapy is often necessary for IPA patients. Preoperative drug therapy can shrink tumor size, facilitating resection and postoperative recovery, mitigating hormone imbalances, delaying recurrence, and enhancing patients' quality of life. Conclusions This article comprehensively reviews the diagnostic criteria for assessing the invasiveness of PAs in the domains of imaging, pathology, and molecular biology, provides an overview of the current research status of drug therapy for these conditions, and deepens our insight into the biological and therapeutic aspects of the tumor microenvironment in PAs. |
| format | Article |
| id | doaj-art-21262c385b0f4375966fb9ba8ea914fa |
| institution | OA Journals |
| issn | 2050-4527 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Immunity, Inflammation and Disease |
| spelling | doaj-art-21262c385b0f4375966fb9ba8ea914fa2025-08-20T01:57:39ZengWileyImmunity, Inflammation and Disease2050-45272024-12-011212n/an/a10.1002/iid3.70098Advancements in Molecular Diagnosis and Pharmacotherapeutic Strategies for Invasive Pituitary AdenomasDingkai Xu0Ling Wang1Maohua Zheng2Department of Neurosurgery The First Hospital of Lanzhou University Lanzhou ChinaDepartment of Endocrinology Liangzhou Hospital Wuwei Gansu ChinaDepartment of Neurosurgery The First Hospital of Lanzhou University Lanzhou ChinaABSTRACT Background The overwhelming majority of pituitary tumors consist of pituitary adenomas (PAs), which have recently also been termed pituitary neuroendocrine tumors (PitNETs). Clinically significant PAs occur in approximately one in every 1000 individuals, while other types of pituitary tumors, such as craniopharyngiomas and pituicytomas, are significantly less common. Although PAs are generally benign, a subset of them exhibits malignant‐like biological traits. They tend to infiltrate and grow aggressively into adjacent tissues and organs, including the dura mater, cavernous sinus, and sphenoid sinus. This invasive behavior often results in the destruction of the normal anatomical architecture of the sella turcica and skull base. Clinically, such tumors are classified as invasive PAs (IPAs), emphasizing their aggressive and destructive nature. Objective and Significance Currently, the diagnostic indicators for IPAs frequently suffer from suboptimal sensitivity and specificity. The invasiveness assessment of PAs lacks a definitive gold standard and instead serves as a predictive tool, with a greater number of indicators met suggesting a higher likelihood of invasiveness. Consequently, a comprehensive approach that integrates imaging, pathological, molecular biological, and other disciplinary metrics is crucial for accurate evaluation. Despite surgery being the primary treatment modality for IPAs, their malignant‐like behavior complicates complete resection, resulting in lower resection rates and heightened postoperative recurrence, necessitating multiple surgeries. Therefore, adjunctive drug therapy is often necessary for IPA patients. Preoperative drug therapy can shrink tumor size, facilitating resection and postoperative recovery, mitigating hormone imbalances, delaying recurrence, and enhancing patients' quality of life. Conclusions This article comprehensively reviews the diagnostic criteria for assessing the invasiveness of PAs in the domains of imaging, pathology, and molecular biology, provides an overview of the current research status of drug therapy for these conditions, and deepens our insight into the biological and therapeutic aspects of the tumor microenvironment in PAs.https://doi.org/10.1002/iid3.70098biomarkerinvasivenessmiRNAoncogenepituitary adenoma |
| spellingShingle | Dingkai Xu Ling Wang Maohua Zheng Advancements in Molecular Diagnosis and Pharmacotherapeutic Strategies for Invasive Pituitary Adenomas Immunity, Inflammation and Disease biomarker invasiveness miRNA oncogene pituitary adenoma |
| title | Advancements in Molecular Diagnosis and Pharmacotherapeutic Strategies for Invasive Pituitary Adenomas |
| title_full | Advancements in Molecular Diagnosis and Pharmacotherapeutic Strategies for Invasive Pituitary Adenomas |
| title_fullStr | Advancements in Molecular Diagnosis and Pharmacotherapeutic Strategies for Invasive Pituitary Adenomas |
| title_full_unstemmed | Advancements in Molecular Diagnosis and Pharmacotherapeutic Strategies for Invasive Pituitary Adenomas |
| title_short | Advancements in Molecular Diagnosis and Pharmacotherapeutic Strategies for Invasive Pituitary Adenomas |
| title_sort | advancements in molecular diagnosis and pharmacotherapeutic strategies for invasive pituitary adenomas |
| topic | biomarker invasiveness miRNA oncogene pituitary adenoma |
| url | https://doi.org/10.1002/iid3.70098 |
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