help button home button Endocrine Society JCEM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
This version published online on October 29, 2009
Journal of Clinical Endocrinology & Metabolism , doi:10.1210/jc.2009-1583
This Article
Right arrow Author Manuscript (PDF)
Right arrow Submit a related Letter to the Editor
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Copyright Permission
Google Scholar
Right arrow Articles by Lupi, I.
Right arrow Articles by Martino, E.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lupi, I.
Right arrow Articles by Martino, E.

Submitted on July 24, 2009
Accepted on September 29, 2009

Tumor Infiltrating Lymphocytes But Not Serum Pituitary Antibodies Are Associated with Poor Clinical Outcome after Surgery in Patients with Pituitary Adenoma

Isabella Lupi, Luca Manetti, Patrizio Caturegli, Michele Menicagli, Mirco Cosottini, Aldo Iannelli, Giovanni Acerbi, Generoso Bevilacqua, Fausto Bogazzi, and Enio Martino*

Department of Endocrinology and Metabolism (I.L., L.M., F.B., E.M.), University of Pisa, 56124 Pisa, Italy; Departments of Pathology (School of Medicine) and Molecular Microbiology and Immunology (School of Public Health) (P.C.), Johns Hopkins University, 21205 Baltimore, Maryland; Division of Surgical, Molecular, and Ultrastructural Pathology (M.M., G.B.), Department of Oncology, and Department of Neuroscience (M.C., A.I., G.A.), University of Pisa, 56100 Pisa, Italy

* To whom correspondence should be addressed. E-mail: emartino{at}endoc.med.unipi.it.

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.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Endocrinology Endocrine Reviews J. Clin. End. & Metab.
Molecular Endocrinology Recent Prog. Horm. Res. All Endocrine Journals
Copyright © 2009 by The Endocrine Society