Figure 4.

Clinical characteristics of patients with Cushing's disease in relation to USP8 mutational status. (A) Frequency of USP8 mutations in male and female patients with Cushing's disease. (B) Representative contrast-enhanced T1 weighted MRI of PAs with or without USP8 mutations. Tumor bulk is indicated by arrows. The WT tumor is very large and invasively extends into the sphenoidal sinus and the cavernous sinus, whereas the mutant tumor is markedly smaller in size and diffusely distributed within the sella. (C) Percentage of cases with invasion in both USP8 WT and mutated groups. Invasive adenomas were defined as fulfilling 1 of 2 conditions: (1) Hardy's modified classification grade III, IV and/or stage C, D and E; (2) Knosp classification grade III and IV. In A and C, the actual number of mutated cases over the total cases analyzed is shown on top of each column. P values were calculated by Pearson's χ² test. (D) Different maximal diameter between USP8 WT and mutated groups. Each symbol (dot) represents an individual case. Lines indicate the median with interquartile range (25% and 75%). The number of patients with each genotype is indicated by n. P values were calculated by the Mann-Whitney U-test.