Clinical and Molecular Characteristics of Gonadotroph Pituitary Tumors According to the WHO Classification

Endocr Pathol. 2024 Mar;35(1):1-13. doi: 10.1007/s12022-023-09794-w. Epub 2023 Dec 14.

Abstract

Since 2017, hormone-negative pituitary neuroendocrine tumors expressing the steroidogenic factor SF1 have been recognized as gonadotroph tumors (GnPT) but have been poorly studied. To further characterize their bio-clinical spectrum, 54 GnPT defined by immunostaining for FSH and/or LH (group 1, n = 41) or SF1 only (group 2, n = 13) were compared and studied for SF1, βFSH, βLH, CCNA2, CCNB1, CCND1, caspase 3, D2R, and AIP gene expression by qRT-PCR. Immunohistochemistry for AIP and/or D2R was performed in representative cases. Overall, patients were significantly younger in group 1 (P = 0.040 vs group 2), with a similar trend excluding recurrent cases (P = 0.078), and no significant difference in gender, tumor size, invasion or Ki67. SF1 expression was similar in both groups but negatively correlated with the patient's age (P = 0.013) and positively correlated with βLH (P < 0.001) expression. Beta-FSH and AIP were significantly higher in group 1 (P = 0.042 and P = 0.024, respectively). Ki67 was unrelated to gonadotroph markers but positively correlated with CCNB1 (P = 0.001) and negatively correlated with CCND1 (P = 0.008). D2R and AIP were strongly correlated with each other (P < 0.001), and both positively correlated with SF1, βFSH, βLH, and CCND1. AIP immunopositivity was frequently observed in both groups, with a similar median score, and unrelated to Ki67. D2R immunostaining was best detected with a polyclonal antibody and mostly cytoplasmic. This study indicates that hormone-negative GnPT tend to occur in older patients but do not significantly differ from other GnPT in terms of invasion or proliferation. It also points out the current limits of D2R immunostaining in such tumors.

Keywords: Aryl hydrocarbon receptor interacting protein (AIP); Cell cycle; Dopamine receptor 2 (D2R); Gonadotroph tumors; Pituitary neuroendocrine tumors (PitNETs); SF1.

MeSH terms

  • Aged
  • Follicle Stimulating Hormone
  • Gonadotrophs* / metabolism
  • Gonadotrophs* / pathology
  • Humans
  • Ki-67 Antigen / metabolism
  • Pituitary Neoplasms* / pathology
  • World Health Organization

Substances

  • Ki-67 Antigen
  • Follicle Stimulating Hormone