endosergЭндокринная хирургияEndocrine Surgery2306-35132310-3965Типография «Печатных дел Мастер»10.14341/serg13007endoserg-13007Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESРоль иммуногистохимического анализа в повышении точности диагностики нейроэндокринных опухолей гипофизаThe role of immunohistochemical analysis in improving the diagnosis accuracy of neuroendocrine tumors of the pituitary glandhttps://orcid.org/0000-0002-6871-2157АсаадВ.AsaadW.

Асаад Валаа.

Москва

Walaa Asaad.

Moscow

walaaakasaad94@gmail.comhttps://orcid.org/0000-0002-8136-0117ПачуашвилиН. В.PachuashviliN. V.

Пачуашвили Нано Владимировна - к.м.н.

Москва

Nano Pachuashvili.

Moscow

npachuashvili@bk.ruhttps://orcid.org/0000-0001-6891-0009УрусоваЛ. С.UrusovaL. S.

Урусова Лилия Сергеевна - д.м.н.

Москва

Liliya Urusova - ScD.

Moscow

liselivanova89@yandex.ruhttps://orcid.org/0000-0003-2122-2297БондаренкоЕ. В.BondarenkoE. V.

Бондаренко Екатерина Владимировна - к.м.н.

Москва

Ekaterina Bondarenko - PhD.

Moscow

bondarenko.ekaterina@endocrincentr.ruhttps://orcid.org/0000-0003-4353-6705ЛапшинаА. М.LapshinaA. M.

Лапшина Анастасия Михайловна - к.м.н.

Москва

Anastasia Lapshina - PhD.

Moscow

anastasya.lapshina@endocrincentr.ruhttps://orcid.org/0000-0001-8144-4188УткинаМ. В.UtkinaM. V.

Уткина Марина Валерьевна - к.б.н., доцент.

Москва

Marina Utkina - PhD.

Moscow

mv.utkina@ya.ruhttps://orcid.org/0000-0003-1172-3557ПоповС. В.PopovS. V.

Попов Сергей Владимирович - к.б.н., доцент.

Москва

Sergey Popov - PhD.

Moscow

popov.sergey@endocrincentr.ruhttps://orcid.org/0000-0002-0327-4619ДзерановаЛ. К.DzeranovaL. K.

Дзеранова Лариса Константиновна - д.м.н.

Москва

Larisa K. Dzeranova - MD, ScD.

Moscow

dzeranovalk@yandex.ruhttps://orcid.org/0000-0001-6539-466XПигароваЕ. А.PigarovaE. A.

Пигарова Екатерина Александровна - д.м.н.

117036, Москва, ул. Дмитрия Ульянова, д. 11

Scopus Author ID 55655098500

Ekaterina A. Pigarova - MD, ScD.

11 Dm. Ulyanova street, 117036 Moscow

Scopus Author ID 55655098500

kpigarova@gmail.comГНЦ РФ ФГБУ «Национальный медицинский исследовательский центр эндокринологии»РоссияEndocrinology Research CentreRussian Federation2025040620251911322Copyright © Асаад В., Пачуашвили Н.В., Урусова Л.С., Бондаренко Е.В., Лапшина А.М., Уткина М.В., Попов С.В., Дзеранова Л.К., Пигарова Е.А., 20252025Асаад В., Пачуашвили Н.В., Урусова Л.С., Бондаренко Е.В., Лапшина А.М., Уткина М.В., Попов С.В., Дзеранова Л.К., Пигарова Е.А.Asaad W., Pachuashvili N.V., Urusova L.S., Bondarenko E.V., Lapshina A.M., Utkina M.V., Popov S.V., Dzeranova L.K., Pigarova E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surg-endojournals.ru/jour/article/view/13007ОБОСНОВАНИЕ

ОБОСНОВАНИЕ. Современная клиническая классификация и принципы лечения опухолей гипофиза в целом отталкиваются от анализа уровней гормонов в плазме крови. Однако такой подход не учитывает особенности гетерогенных и плюригормональных опухолей, представляющих значительные диагностические трудности. Иммуногистохимический анализ (ИГХ) является важным инструментом для изучения молекулярных особенностей удаленной опухоли, позволяя выявлять характеристики, неочевидные при стандартных биохимических тестах и клинической оценке.

ЦЕЛЬ

ЦЕЛЬ. Изучение гетерогенности опухолей гипофиза и коэкспрессии гормонов путем сравнительного анализа клинико-гормональных и иммуногистохимических данных для оптимизации диагностики и классификации нейроэндокринных опухолей (НЭО) гипофиза.

МАТЕРИАЛЫ И МЕТОДЫ

МАТЕРИАЛЫ И МЕТОДЫ. В исследование включены 10 образцов опухолей гипофиза. Проведен комплексный иммуногистохимический анализ, направленный на изучение экспрессии транскрипционных факторов и гипофизарных гормонов с целью выявления гетерогенности опухолей и возможной коэкспрессии гормонов.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. Анализ подтвердил наличие выраженной гетерогенности опухолей гипофиза, а также выявил случаи коэкспрессии гормонов в отдельных опухолях, которые могут оставаться незамеченными при изучении только клинических данных и результатов анализа крови пациента или при отсутствии ИГХ-исследования, на выявление всех основных гормонов и факторов транскрипции в тканях гипофиза. В ходе нашего исследования мы выявили гетерогенность в образцах опухолей гипофиза на уровне экспрессии транскрипционных факторов и гормонов. Например, в двух гормонально-активных кортикотропиномах, помимо экспрессии стандартных ИГХ маркеров, была обнаружена экспрессия GH и PIT1, тогда как в соматотропиномах выявлена отчетливая экспрессия SF1, транскрипционного фактора, высокоспецифичного для гонадотропных клеток. Кроме того, нами зафиксированы признаки гетерогенности в гормонально-неактивных опухолях гипофиза, таких как молчащие гонадотропиномы, в которых была выявлена экспрессия как SF1, так и TPIT.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. Результаты исследования подтвердили выраженную гетерогенность опухолей гипофиза и наличие экспрессии гормонов методом ИГХ-окрашивания, что свидетельствует о сложности их диагностики при использовании только клинико-гормональных методов. Комплексный иммуногистохимический анализ играет ключевую роль в точной классификации этих опухолей, что может способствовать совершенствованию диагностических и терапевтических подходов.

BACKGROUND

BACKGROUND: The current clinical classification and treatment principles for pituitary adenomas are primarily based on the analysis of hormone levels in blood plasma. However, this approach does not account for the heterogeneity and plurihormonal nature of these tumors, which pose significant diagnostic challenges. Immunohistochemical (IHC) analysis is a crucial tool for studying the molecular characteristics of resected tumors, enabling the identification of features that may not be apparent through standard biochemical tests and clinical evaluation.

AIM

AIM: To investigate the heterogeneity and hormone co-expression of pituitary adenomas through a comparative analysis of clinical, hormonal, and immunohistochemical data, aiming to optimize the diagnosis and classification of pituitary neuroendocrine tumors.

MATERIALS AND METHODS

MATERIALS AND METHODS: The study included 10 pituitary adenoma samples. A comprehensive immunohistochemical analysis was performed to evaluate the expression of transcription factors and pituitary hormones to detect tumor heterogeneity and potential plurihormonal pituitary adenomas.

RESULTS

RESULTS: The analysis confirmed significant heterogeneity of pituitary adenomas and identified cases of hormone co-­expression in certain tumors, which may be overlooked when relying solely on clinical data and blood test results, or in the absence of IHC testing that covers all hormones and transcription factors in pituitary tissue. In our study, we identified heterogeneity in pituitary adenoma samples at the level of transcription factor and hormone expression. For example, in two hormonally active corticotropinomas, we observed not only the expression of standard IHC markers but also the unexpected expression of GH and PIT1. Notably, somatotropinomas exhibited distinct expression of SF1, a transcription factor typically specific to gonadotroph cells. Additionally, we identified signs of heterogeneity in hormone-inactive pituitary tumors — such as silent gonadotropinomas — where co-expression of both SF1 and TPIT was detected.

CONCLUSION

CONCLUSION: The results of the study confirmed significant heterogeneity of pituitary adenomas and the presence of hormone co-expression, indicating the complexity of their diagnosis when relying solely on clinical and hormonal methods. Comprehensive immunohistochemical analysis plays a key role in the accurate classification of these tumors, which may contribute to the improvement of diagnostic and therapeutic approaches.

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The authors declare that there are no conflicts of interest present.