Clinicopathological Features of Growth Hormone-Producing Pituitary Adenomas in 242 Acromegaly Patients: Classification according to Hormone Production and Cytokeratin Distribution

Table 2

Clinical, endocrinological, and histological summary of growth hormone producing adenomas.

Total cases (𝑛=242)

Hormonal type

GH adenoma (𝑛=108)

GH-PRL adenoma (𝑛=103)

GH-TSH adenoma (𝑛=18)

GH-PRL-TSH adenoma (𝑛=13)

Cytokeratin staining

PP (𝑛=78)

PP (𝑛=90)

PP (𝑛=16)

PP (𝑛=13)

P-pre; (𝑛=46)

P-inter; (𝑛=32)

DP; (𝑛=26)

NP; (𝑛=4)

P-pre; (𝑛=26)

P-inter; (𝑛=64)

DP; (𝑛=6)

NP; (𝑛=7)

P-pre; (𝑛=7)

P-inter; (𝑛=9)

DP; (𝑛=0)

NP; (𝑛=2)

P-pre; (𝑛=5)

P-inter; (𝑛=8)

DP; (𝑛=0)

NP; (𝑛=0)

Age

49.8±13.0

41.3±7.80^a

46.2±15.4

50.1±13.1

45.8±12.5

34.4±15.2^b

45.8±12.0

—

41.5±10.6

49.5±13.1

—

—

49.2±12.5

50.7±13.9

44.7±14.6

52.2±11.9

48.0±12.6

44.1±12.1

52.2±7.25

47.8±16.1

Sex (M/F)

42/38

7/19^c

3/1

40/50

2/4

2/5

8/8

—

1/1

4/9

—

—

22/24

18/14

15/11

25/39

5/2

3/6

3/2

1/7

Cases without preoperative medical therapy (𝑛=177)

Hormonal type

GH adenoma (𝑛=67)

GH-PRL adenoma (𝑛=87)

GH-TSH adenoma (𝑛=13)

GH-PRL-TSH adenoma (𝑛=10)

Cytokeratin staining

PP (𝑛=47)

PP (𝑛=77)

PP (𝑛=11)

PP (𝑛=10)

P-pre; (𝑛=24)

P-inter; (𝑛=23)

DP; (𝑛=17)

NP; (𝑛=3)

P-pre; (𝑛=21)

P-inter; (𝑛=56)

DP; (𝑛=4)

NP (𝑛=6)

P-pre; (𝑛=6)

P-inter; (𝑛=5)

DP; (𝑛=0)

NP (𝑛=2)

P-pre; (𝑛=3)

P-inter (𝑛=7)

DP; (𝑛=0)

NP; (𝑛=0)

Age

54.4±11.9

40.6±7.69

51.6±13.5

50.3±13.3

45.5±16.1

37.1±14.7

46.3±13.2

—

41.5±10.6

47.3±13.9

—

—

54.4±10.8

54.5±13.2

45.7±15.4

52.0±12.1

48.0±13.8

44.4±13.8

50.0±5.56

46.1±16.5

Sex (M/F)

25/22

5/12

3/0

35/42

1/3

2/4

5/6

—

1/1

3/7

—

—

14/10

11/12

14/7

21/35

4/2

1/4

2/1

1/6

GH (basal) (ng/mL)

17.6±24.9

17.0±14.7

25.0±21.1

17.8±48.8

14.6±8.84

4.26±3.00^d

12.0±10.9

—

2.65±0.77

17.5±14.0

—

—

19.7±32.0

15.3±14.5

30.5±89.6

13.1±17.0

14.1±12.9

9.44±8.73

11.4±9.23

20.1±15.5

IGF-1 (U/mL)

650±269

631±275

665±332

626±245

606±144

497±298

574±264

—

479±203

621±187

—

—

649±251

652±293

749±297

581±207

561±299

589±247

549±82.6

653±215

PRL (ng/mL)

9.10±3.87

15.4±11.7

7.73±2.10

46.0±95.9^e

55.4±87.8

29.8±45.1

44.2±113

—

8.35±4.17

21.9±13.5^f

—

—

10.1±4.63

8.13±2.62

58.5±161

41.6±58.6

11.7±8.60

83.1±168

17.2±13.1

23.9±14.2

TSH (μIU/mL)

0.80±0.87

0.57±0.34

0.72±0.16

0.90±0.74

0.39±0.28

0.63±0.44

0.85±0.49

—

0.78±0.10

0.66±0.25

—

—

1.00±1.12

0.54±0.36

0.92±0.62

0.89±0.78

0.62±0.42

1.11±0.46

0.66±0.41

0.66±0.19

Maximum tumor diameter (mm)

13.8±6.06

21±5.67^g

19±5.19^h

13.8±6.35

12.2±2.06

17.1±4.26^i

17.9±13.1

—

27.5±27.5

14.7±7.66

—

—

15.2±7.13

12.4±4.47

15.6±8.83

13.1±5.07

23.3±15.6

11.4±5.50

11.3±4.93

16.1±8.47

Micro (−10 mm)/; Macro (>10 mm)

17/30

0/17

0/3

33/44

1/3

0/6

3/8

—

1/1

4/6

—

—

7/17

10/13

8/13

25/31

1/5

2/3

2/1

2/5

Tumor volume (cm^3)

1.28±2.29

3.02±3.43^j

1.69±1.11^k

1.18±3.00

0.51±0.41

1.76±1.56^l

3.08±5.20

—

1.09±1.53

1.88±3.60

—

—

1.77±3.09

0.78±0.68

2.26±5.44

0.78±1.05

5.18±6.49

0.56±0.53

0.82±1.05

2.33±4.27

Knosp (3,4)

13%

71%^m

0%

17%

0%

33%

27%

—

50%

30%

—

—

17%

9%

19%

16%

50%

0%

33%

29%

Sphenoid sinus invasion

13%

12%

0%

18%

0%

0%

36%

—

50%

10%

—

—

17%

9%

24%

16%

33%

40%

33%

0%

GH: growth hormone; PRL: prolactin; TSH: thyroid stimulating hormone; PP: perinuclear pattern; DP: dot pattern; NP: negative pattern; P-pre: perinuclear predominant pattern; P-inter: perinuclear intermediate pattern; IGF-1: insulin-like growth factor-1; M: male; F: female.
^aSignificantly younger compared with PP GH (𝑃=0.002), GH-PRL (𝑃=0.0007), and GH-PRL-TSH (𝑃=0.01) adenomas. ^bSignificantly younger compared with PP GH (𝑃=0.01), GH-PRL (𝑃=0.01), and GH-PRL-TSH (𝑃=0.03) adenomas. ^cSignificant female predominance compared with PP GH (𝑃=0.03) adenomas. ^dSignificantly lower compared with PP GH (𝑃=0.01), GH-PRL (𝑃=0.03), and GH-PRL-TSH (𝑃=0.03) adenomas. ^eSignificantly higher compared with PP (𝑃<0.0001), DP (𝑃=0.01), NP (𝑃=0.01) GH adenomas, and PP GH-TSH (𝑃=0.02) adenomas. ^fSignificantly higher compared with PP (𝑃=0.0005), NP (𝑃=0.02) of GH adenomas, and PP GH-TSH (𝑃=0.04) adenomas. ^gSignificantly larger compared with PP GH (𝑃<0.0001), GH-PRL (𝑃<0.0001), GH-PRL-TSH (𝑃=0.004) adenomas, and DP GH-PRL (𝑃=0.004) adenomas. ^hSignificantly larger compared with PP (𝑃=0.04), DP (𝑃=0.01) GH-PRL adenomas. ⁱSignificantly larger compared with PP of GH-PRL (𝑃=0.03) adenomas. ^jSignificantly larger compared with PP GH (𝑃<0.0001), GH-PRL (𝑃<0.0001), GH-PRL-TSH (𝑃=0.006) adenomas, and DP GH-PRL (𝑃=0.004) adenomas. ^kSignificantly larger compared with PP (𝑃=0.03) and DP (𝑃=0.03) of GH-PRL adenomas. ^lSignificantly larger compared with PP of GH-PRL (𝑃=0.04) adenomas. ^mSignificant cavernous sinus invasion compared with PP (𝑃<0.0001), NP (𝑃=0.02) GH adenomas, PP (𝑃<0.0001), DP (𝑃=0.01) GH-PRL adenomas, PP GH-TSH (𝑃=0.02) adenomas, and GH-PRL-TSH (𝑃=0.04) adenomas.