Open AccessClinical, Pathological, and Molecular Factors of Aggressiveness in Lactotroph Tumours
Author(s) -
Jacqueline Trouillas,
Etienne Delgrange,
Anne Wierinckx,
Alexandre Vasiljevic,
Emmanuel Jouanneau,
Pia Burman,
Gérald Raverot
Publication year - 2019
Publication title -
neuroendocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.493
H-Index - 101
eISSN - 1423-0194
pISSN - 0028-3835
DOI - 10.1159/000499382
Subject(s) - prolactinoma , malignancy , prolactin cell , biology , metastasis , epidermal growth factor , medicine , vascular endothelial growth factor , pathological , cancer research , pathology , prolactin , endocrinology , oncology , cancer , receptor , genetics , hormone , vegf receptors
The behaviour of lactotroph tumours varies between benign tumours, those cured by treatment, and that of aggressive tumours, and carcinomas with metastasis. Identification of clinical, pathological and molecular factors is essential for the early identification of patients that may have such aggressive tumours. Plasma prolactin levels and tumour size and invasion, per se, are not prognostic factors. However, tumours appearing at a young age ( 2) are correlated to invasion and proliferation, but, taken alone, their prognostic value is debatable. Based on a 5-tiered clinicopathological classification, and taking into account invasion and proliferation, a grade 2b (aggressive) lactotroph tumour has a 20× risk of progression compared to a grade 1a (benign) tumour. Moreover, lactotroph tumours are the second-most frequent aggressive and malignant tumour. Other factors, such as the expression of growth factors (vascular endothelial growth factor [VEGF] and epidermal growth factor [EGF]), the genes regulating invasion, differentiation and proliferation, adhesion molecules (E-cadherin), matrix metalloproteinase 9, and chromosome abnormalities (chromosomes 11, 19, and 1), have also been correlated with aggressiveness. Currently, clinical signs, a prognostic classification, and molecular and genetic markers may all help the clinician in the early identification of aggressive lactotroph tumours and enable stratification of their management.