Prognostic factors in prolactin pituitary tumors: clinical, histological, and molecular data from a series of 94 patients with a long postoperative follow-up.
OBJECTIVE
Predicting pituitary tumor behavior remains a challenge. This multiparameter investigation aimed to identify markers for recurrence and progression in prolactin tumors.


METHODS
From a cohort of patients treated for prolactin tumors by surgery, we retrospectively studied clinical data, tumor characteristics, clinical outcome, and the expression of nine genes by quantitative RT-PCR.


RESULTS
This study included 94 patients (62 females and 32 men), with long postoperative follow-up periods (mean, 138 +/- 46 months); 54.3% of patients had a macro or giant adenoma. Tumors were classified into three pathological groups based on their radiological and histological characteristics (noninvasive, 61; invasive, 22; and aggressive-invasive, 11). Immediately after surgery, 60 patients (63.8%) went into remission (prolactin level normalization). Persistently elevated prolactin levels (36.2%) were associated with increasing age, male sex, high preoperative prolactin levels, large tumor size on univariate analysis, and invasion and pathological classification on univariate and multivariate (P = 8 x 10(-10) and 3 x 10(-8)) analysis. During follow-up, 19 patients (20%) had tumors that recurred or progressed under dopamine agonist treatment. Invasion and pathological classification were associated with recurrence or progression on univariate analysis. Seven genes (ADAMTS6, CRMP1, PTTG, ASK, CCNB1, AURKB, and CENPE) were associated with tumor recurrence or progression and five of these (ADAMTS6, CRMP1, ASK, CCNB1, and CENPE) were associated with the pathological classification.


CONCLUSIONS
This study identifies both the clinical and histological factors that relate to prolactin tumor recurrence or progression. Molecular markers give additional information for prognosis of such tumors. Altogether, our results could influence the management of patients with pituitary tumors.
Raverot
Gérald
G
Institut National de la Santé et de la Recherche Médicale, Unité 842, Université de Lyon, Lyon 1, Unité Mixte de Recherche (UMR) S842, Faculté de Médecine Lyon-Est, F-69372 Lyon, Cedex 08, France. jacqueline.trouillas@recherche.univ-lyon1.fr
Wierinckx
Anne
A
Dantony
Emmanuelle
E
Auger
Carole
C
Chapas
Guillaume
G
Villeneuve
Laurent
L
Brue
Thierry
T
Figarella-Branger
Dominique
D
Roy
Pascal
P
Jouanneau
Emmanuel
E
Jan
Michel
M
Lachuer
Joël
J
Trouillas
Jacqueline
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D018076:DNA, Complementary / Q000096:biosynthesis / Q000235:genetics; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015870:Gene Expression; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010907:Pituitary Hormones / Q000235:genetics; D010911:Pituitary Neoplasms / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D015175:Prolactinoma / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D012313:RNA / Q000096:biosynthesis / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D055815:Young Adult
D018076:DNA, Complementary; D010907:Pituitary Hormones; D012313:RNA