ArticleActa neuropathologica communications2015
Histological criteria for atypical pituitary adenomas - data from the German pituitary adenoma registry suggests modifications.
Article in Acta neuropathologica communications, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 58 papers, 2 of them syntheses that pooled it.
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Who cites it
58 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clinical and radiological presentation of parasellar ectopic pituitary adenomas: case series and systematic review of the literature.Journal of endocrinological investigation · 2022Pooled it
- Ki67 in endocrine neoplasms: to count or not to count, this is the question! A systematic review from the English language literature.Journal of endocrinological investigation · 2020Pooled it
- Clinical characteristics and prognostic outcomes of silent corticotroph versus gonadotroph adenomas: A 603-case single-center cohort study.Neurosurgical review · 2026Article
- Can acromegaly be controlled in all cases?Journal of neuroendocrinology · 2026Review
- Role of Surgery in the Multimodal Treatment of Pituitary Carcinoma: A Retrospective Single-Institution Case Series.Cancers · 2026Article
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- Navigating prognostic strategies for GH- and PRL-secreting pituitary neuroendocrine tumors: key insights from a clinicopathological study.Frontiers in endocrinology · 2025Article
- Clinicopathological analysis of non-functioning pituitary adenomas (PAs) according to the 2022 WHO classification.Pituitary · 2024Article
- [Quantification of Ki-67 in PitNET (pituitary neuroendocrine tumors)/adenomas].Pathologie (Heidelberg, Germany) · 2024Article
- Feasibility of Early Surgical Treatment for Adolescent Patients with Prolactinoma: A Case Report and Literature Review.Medicina (Kaunas, Lithuania) · 2024Review
- Relevance of mutations in protein deubiquitinases genes andFrontiers in endocrinology · 2024Article
- Prolactin-secreting pituitary adenomas: male-specific differences in pathogenesis, clinical presentation and treatment.Frontiers in endocrinology · 2024Review
- MRI and Trouillas' grading system of pituitary tumors: the usefulness of T2 signal intensity volumetric values.Neuroradiology · 2023Article
- Article
- PKCθ Regulates Pituitary Adenoma Bone Invasion by Activating Osteoclast in NF-κB/IL-1β-Dependent Manner.Cancers · 2023Article
- Cystic versus non-cystic silent corticotrophic adenomas: clinical and histological analysis of 62 cases after microscopic transsphenoidal surgery-a retrospective, single-center study.Scientific reports · 2023Article
- The evolution in pituitary tumour classification: a clinical perspective.Endocrine oncology (Bristol, England) · 2023Review
- Prognostic Factors for Invasiveness and Recurrence of Pituitary Adenomas: A Series of 94 Patients.Diagnostics (Basel, Switzerland) · 2022Article
- Aggressive nonfunctioning pituitary neuroendocrine tumors.Brain tumor pathology · 2022Review
- Aggressive pituitary tumours and carcinomas, characteristics and management of 171 patients.European journal of endocrinology · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe term atypical pituitary adenoma (APA) was revised in the 2004 World Health Organization (WHO) classification of pituitary tumors. However, two of the four parameters required for the diagnosis of APAs were formulated rather vaguely (i.e., "extensive" nuclear staining for p53; "elevated" mitotic index). Based on a case-control study using a representative cohort of typical pituitary adenomas and APAs selected from the German Pituitary Tumor Registry, we aimed to obtain reliable cut-off values for both p53 and the mitotic index. In addition, we analyzed the impact of all four individual parameters (invasiveness, Ki67-index, p53, mitotic index) on the selectivity for differentiating both adenoma subtypes.
methodsOf the 308 patients included in the study, 98 were diagnosed as APAs (incidence 2.9 %) and 10 patients suffered from a pituitary carcinoma (incidence 0.2 %). As a control group, we selected 200 group matched patients with typical pituitary adenomas (TPAs). Cut-off values were attained using ROC analysis.
resultsWe determined significant threshold values for p53 (≥2 %; AUC: 0.94) and the mitotic index (≥2 mitosis within 10 high power fields; AUC: 0.89). The most reliable individual marker for differentiating TPAs and APAs was a Ki-67-labeling index ≥ 4 % (AUC: 0.98). Using logistic regression analysis (LRA) we were able to show that all four criteria (Ki-67 (p < 0.001); OR 5.2// p53 (p < 0.001); OR 3.1// mitotic index (p < 0.001); OR 2.1// invasiveness (p < 0.001); OR 8.2)) were significant for the group of APAs. Furthermore, we describe the presence of nucleoli as a new favorable parameter for TPAs (p = 0.008; OR: 0.4; CI95 %: 0.18; 0.77).
conclusionsHere we present a proposed rectification of the current WHO classification of pituitary tumors describing an additional marker for TPA and specific threshold values for p53 and the mitotic index. This will greatly help in the reliable diagnosis of APAs and facilitate further studies to ascertain the prognostic relevance of this categorization.
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