TY - JOUR
T1 - Tumor infiltrating lymphocytes but not serum pituitary antibodies are associated with poor clinical outcome after surgery in patients with pituitary adenoma
AU - Lupi, Isabella
AU - Manetti, Luca
AU - Caturegli, Patrizio
AU - Menicagli, Michele
AU - Cosottini, Mirco
AU - Iannelli, Aldo
AU - Acerbi, Giovanni
AU - Bevilacqua, Generoso
AU - Bogazzi, Fausto
AU - Martino, Enio
N1 - Funding Information:
This work was supported in part by grants from the Ministero dell'Istruzione, Università e Ricerca (Rome, Italy), University of Pisa (Fondi d'Ateneo per la Ricerca) (to E.M.), and National Institutes of Health Grant DK080351 (to P.C.) .
PY - 2010/1
Y1 - 2010/1
N2 - Context: Serum pituitary antibodies (Pit Abs) and tumor-infiltrating lymphocytes (TILs) have been described in pituitary adenomas, but their clinical significance remains unknown. Objective: The objective of the study was to assess Pit Abs and TILs prevalence in pituitary adenomas and their influence on clinical outcome. Design: This was a prevalence case-control study. Patients and Setting: Two hundred ninety-one pituitary adenoma cases (110 non-secreting, 30 ACTH-69 GH-71 prolactin- and 13 TSH-secreting adenoma; 177 operated and 114 untreated), 409 healthy controls, and 14 autoimmune hypophysitis were enrolled in a tertiary referral center. Intervention: Pit Abs were measured using immunofluorescence in all cases and controls (n=714). The presence of TILs was evaluated using CD45 staining in a subset of adenomas surgically treated (n = 72). Main Outcome Measure: Clinical response of pituitary adenoma after surgery was evaluated. Results: Pit Abs prevalence was higher in adenomas (5.1%) than healthy subjects (0.7%, P<0.0001) and lower than in autoimmune hypophysitis patients (57%, P < 0.0001). Similarly, TILs prevalence was higher in adenomas than normal pituitary (P=0.01) and lower than in autoimmune hypophysitis (P < 0.0001). No correlation between Pit Abs and TILs was found (P= 0.78). A poor clinical outcome was more common in adenoma patients with TILs (11 of 18, 61%) than in those without (17 of 54, 31%, P = 0.026). Multivariate regression analysis identified the presence of TILs as independent prognostic factor for persistence/recurrence of pituitary adenoma. Conclusions: TILs and Pit Abs are present in a significant number of pituitary adenoma patients. Cell-mediated immunity appears to be predictive of a less favorable clinical outcome.
AB - Context: Serum pituitary antibodies (Pit Abs) and tumor-infiltrating lymphocytes (TILs) have been described in pituitary adenomas, but their clinical significance remains unknown. Objective: The objective of the study was to assess Pit Abs and TILs prevalence in pituitary adenomas and their influence on clinical outcome. Design: This was a prevalence case-control study. Patients and Setting: Two hundred ninety-one pituitary adenoma cases (110 non-secreting, 30 ACTH-69 GH-71 prolactin- and 13 TSH-secreting adenoma; 177 operated and 114 untreated), 409 healthy controls, and 14 autoimmune hypophysitis were enrolled in a tertiary referral center. Intervention: Pit Abs were measured using immunofluorescence in all cases and controls (n=714). The presence of TILs was evaluated using CD45 staining in a subset of adenomas surgically treated (n = 72). Main Outcome Measure: Clinical response of pituitary adenoma after surgery was evaluated. Results: Pit Abs prevalence was higher in adenomas (5.1%) than healthy subjects (0.7%, P<0.0001) and lower than in autoimmune hypophysitis patients (57%, P < 0.0001). Similarly, TILs prevalence was higher in adenomas than normal pituitary (P=0.01) and lower than in autoimmune hypophysitis (P < 0.0001). No correlation between Pit Abs and TILs was found (P= 0.78). A poor clinical outcome was more common in adenoma patients with TILs (11 of 18, 61%) than in those without (17 of 54, 31%, P = 0.026). Multivariate regression analysis identified the presence of TILs as independent prognostic factor for persistence/recurrence of pituitary adenoma. Conclusions: TILs and Pit Abs are present in a significant number of pituitary adenoma patients. Cell-mediated immunity appears to be predictive of a less favorable clinical outcome.
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U2 - 10.1210/jc.2009-1583
DO - 10.1210/jc.2009-1583
M3 - Article
C2 - 19875479
AN - SCOPUS:75149182253
SN - 0021-972X
VL - 95
SP - 289
EP - 296
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 1
ER -