Modern classifications of pituitary neuroendocrine tumors
AbstractThis review is devoted to the discussion of new trends in the identification of pituitary tumors and the assessment of the prospects of modern morpho-functional and prognostic classifications that ensure the implementation of a personalized approach to the treatment of patients. Information is provided on the World Health Organization classification of 2017, as well as subsequent modifications dedicated to pituitary tumors [according to the new version - pituitary neuroendocrine tumors (PitNET)]. The fundamental difference of the new edition is the stratification of pituitary tumors according to their belonging to a certain adenohypophysial cell line, followed by the categorization of histological variants according to the hormonal content and the presence of specific histological and immunohistochemical signs.
The paper describes the historical aspects of the gradual improvement of the classification of pituitary adenomas, as well as the role of transcription factors in the translational species differentiation of adenohypophysis cells. Detailed characteristics of various morphological variants of functional and nonfunctional pituitary tumors are given, as well as a list of specific biological markers that facilitate diagnostic search. A list of pituitary adenomas characterized by an increased risk of recurrence and a negative clinical prognosis is presented. The proposed prognostic classification and standardized diagnostic protocol can provide real assistance to clinicians in the adequate postoperative curation of potentially aggressive neuroendocrine pituitary tumors and provide comparable comparative studies on the prognosis of the disease and the effectiveness of secondary therapy.
Keywords:pituitary adenoma, transcription factors, classification of pituitary neuroendocrine tumors, aggressive tumors
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Pronin V.S., Antsiferov M.B., Alekseeva T.M., Pronin E.V. Modern classifications of pituitary neuroendocrine tumors. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2021; 10 (2): 48-64. DOI: https://doi.org/10.33029/2304-9529-2021-10-2-48-64 (in Russian)
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