April - June 2020, Volume 16, Issue 2

Kwinta B, Myszka A, Krzyzewski RM, Klis KM, Dragan MR, Adamek D

Assessment and Comparison of Hormonal Immunoexpression and the Clinical Picture in Patients with Pituitary Adenomas

Acta Endo (Buc) 2020, 16 (2): 148-155
doi: 10.4183/aeb.2020.148

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: transsphenoidal surgery, pituitary adenoma, hormonal immunoexpression, adenoma symptoms

Correspondence: Borys Kwinta MD, Jagiellonian University Medical College, Department of Neurosurgery and Neurotraumatology, Botaniczna 3 Street, 31-503 Krakow, Poland, Tel: +12-424-86-62, E-mail: borys.kwinta@uj.edu.pl