Table 2.
Clinical, endocrinological, and histological summary of growth hormone producing adenomas.
| Total cases (n = 242) | ||||||||||||||||
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| 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) |
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| Age | 49.8 ± 13.0 | 41.3 ± 7.80a | 46.2 ± 15.4 | 50.1 ± 13.1 | 45.8 ± 12.5 | 34.4 ± 15.2b | 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 | 7/19c | 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 | |||||||||
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| Cases without preoperative medical therapy (n = 177) | ||||||||||||||||
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| 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) |
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| 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 ± 3.00d | 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 ± 95.9e | 55.4 ± 87.8 | 29.8 ± 45.1 | 44.2 ± 113 | — | 8.35 ± 4.17 | 21.9 ± 13.5f | — | — | ||||
| 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 ± 5.67g | 19 ± 5.19h | 13.8 ± 6.35 | 12.2 ± 2.06 | 17.1 ± 4.26i | 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 (cm3) | 1.28 ± 2.29 | 3.02 ± 3.43j | 1.69 ± 1.11k | 1.18 ± 3.00 | 0.51 ± 0.41 | 1.76 ± 1.56l | 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.