title: Prognostic factors in prolactin pituitary tumors: clinical, histological, and molecular data from a series of 94 patients with a long postoperative follow-up.
abstract: 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.
authors.affiliation: 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
authors.forename: Gérald
authors.initials: G
authors.lastname: Raverot
authors.forename: Anne
authors.initials: A
authors.lastname: Wierinckx
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Dantony
authors.forename: Carole
authors.initials: C
authors.lastname: Auger
authors.forename: Guillaume
authors.initials: G
authors.lastname: Chapas
authors.forename: Laurent
authors.initials: L
authors.lastname: Villeneuve
authors.forename: Thierry
authors.initials: T
authors.lastname: Brue
authors.forename: Dominique
authors.initials: D
authors.lastname: Figarella-Branger
authors.forename: Pascal
authors.initials: P
authors.lastname: Roy
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Jouanneau
authors.forename: Michel
authors.initials: M
authors.lastname: Jan
authors.forename: Joël
authors.initials: J
authors.lastname: Lachuer
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Trouillas
mesh_terms: 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
chemical_list: D018076:DNA, Complementary; D010907:Pituitary Hormones; D012313:RNA