The Role of T-box Transcription Factor in a Pituitary Adenoma Diagnostic Algorithm.
* Context.--We previously examined pituitary adenomas with immunohistochemical (IHC) stains for steroidogenic factor 1, Pit-1, anterior pituitary hormones, cytokeratin CAM 5.2, and the a-subunit of human chorionic gonadotropin and found that a screening panel comprising stains for steroidogenic fact...
| Publicado en: | Archives of Pathology & Laboratory Medicine Vol. 145; no. 5; pp. 592 - 599 |
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| Autores principales: | , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
College of American Pathologists
May2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=150055455&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 150055455 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00039985 1FS jtl: Archives of Pathology & Laboratory Medicine issn: 00039985 maglogo: N pubinfo: dt: May2021 vid: 145 iid: 5 pid: 2550 pub: College of American Pathologists place: Northfield, Illinois artinfo: ui: 150055455 150055455 150055455 10.5858/arpa.2020-0091-OA 150055455 ppf: 592 ppct: 7 formats: fmt: @attributes: type: P tig: atl: The Role of T-box Transcription Factor in a Pituitary Adenoma Diagnostic Algorithm. aug: au: McDonald, William C. McDonald, Kelsey N. Helmer, Jordan A. Ho, Bridget Wang, Amber Banerji, Nilanjana affil: Department of Pathology and Laboratory Medicine, Allina Health Laboratories, Minneapolis, Minnesota sug: subj: Adenoma, Pituitary Diagnosis Algorithms Transcription Factors Metabolism Immunohistochemistry Staining and Labeling Adenoma, Pituitary Classification Cancer Screening Methods Human Cancer Patients Cancer Care Facilities Tissue Array Analysis Serologic Tests Correlational Studies Cluster Analysis Descriptive Statistics Sensitivity and Specificity Predictive Value of Tests ab: * Context.--We previously examined pituitary adenomas with immunohistochemical (IHC) stains for steroidogenic factor 1, Pit-1, anterior pituitary hormones, cytokeratin CAM 5.2, and the a-subunit of human chorionic gonadotropin and found that a screening panel comprising stains for steroidogenic factor 1, Pit-1, and adrenocorticotropic hormone successfully classified most cases and reduced the overall number of stains required. Objectives.--To examine the potential role of IHC stain for T-box transcription factor (Tpit) in the classification of our series of pituitary adenomas and to update our screening panel as necessary. Design.--We collected 157 pituitary adenomas from 2 institutions and included these in tissue microarrays. Immunostains for Tpit were scored in a blinded fashion using the Allred system. Adenomas were assigned to a gold standard class based on IHC pattern followed by application of available clinical and serologic information. Test characteristics were calculated. Correlation analyses, cluster analyses, and classification tree analyses were used to see whether IHC staining patterns reliably reflected adenoma class. Results.--Of the cases collected, 147 (93.6%) had sufficient material for Tpit analysis. IHC stain for Tpit identified 8 null cell adenomas (all nonfunctioning clinically) as silent corticotrophs; Tpit stains showed better sensitivity, specificity, positive predictive value, and negative predictive value than IHC for adrenocorticotropic hormone and cytokeratin CAM 5.2. Correlation analyses continued to show the expected relationships among IHC stains. Cluster analyses showed grouping of adenomas into clinically consistent groups. Classification tree analysis underscored the central role of transcription factor IHC stains, including Tpit, in adenoma classification. Conclusions.--Substitution of Tpit stain for the adrenocorticotropic hormone stain improves our prior algorithm by reducing the number of false-negatives and falsepositives. As a result, fewer adenomas are classified as null cell adenoma, and more adenomas are classified as silent corticotroph adenoma. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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