Digital image analysis allows objective stratification of patients with silent PIT1‐lineage pituitary neuroendocrine tumors

Abstract Studies describing the clinical presentation and prognosis of patients with silent PIT1 (pituitary specific transcription factor)‐lineage pituitary neuroendocrine tumors (PitNETs) are rare. We identified patients with positive PIT1 tumor staining but without evidence of hormone hypersecreti...

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Main Authors: Jiangyan Zhao (Author), Chenxing Ji (Author), Haixia Cheng (Author), Zhen Ye (Author), Boyuan Yao (Author), Ming Shen (Author), Xuefei Shou (Author), Xiang Zhou (Author), Hongying Ye (Author), Zhaoyun Zhang (Author), Hong Chen (Author), Yongfei Wang (Author), Fuchu He (Author), Yao Zhao (Author), Wei Gong (Author), Qilin Zhang (Author), Nidan Qiao (Author)
Format: Book
Published: Wiley, 2023-11-01T00:00:00Z.
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100 1 0 |a Jiangyan Zhao  |e author 
700 1 0 |a Chenxing Ji  |e author 
700 1 0 |a Haixia Cheng  |e author 
700 1 0 |a Zhen Ye  |e author 
700 1 0 |a Boyuan Yao  |e author 
700 1 0 |a Ming Shen  |e author 
700 1 0 |a Xuefei Shou  |e author 
700 1 0 |a Xiang Zhou  |e author 
700 1 0 |a Hongying Ye  |e author 
700 1 0 |a Zhaoyun Zhang  |e author 
700 1 0 |a Hong Chen  |e author 
700 1 0 |a Yongfei Wang  |e author 
700 1 0 |a Fuchu He  |e author 
700 1 0 |a Yao Zhao  |e author 
700 1 0 |a Wei Gong  |e author 
700 1 0 |a Qilin Zhang  |e author 
700 1 0 |a Nidan Qiao  |e author 
245 0 0 |a Digital image analysis allows objective stratification of patients with silent PIT1‐lineage pituitary neuroendocrine tumors 
260 |b Wiley,   |c 2023-11-01T00:00:00Z. 
500 |a 2056-4538 
500 |a 10.1002/cjp2.340 
520 |a Abstract Studies describing the clinical presentation and prognosis of patients with silent PIT1 (pituitary specific transcription factor)‐lineage pituitary neuroendocrine tumors (PitNETs) are rare. We identified patients with positive PIT1 tumor staining but without evidence of hormone hypersecretion at a tertiary center. Clusters were obtained according to cell morphology and immunostaining from each patient's digitally segmented whole slide image. We compared the clinical presentations, radiological features, and prognoses of the different clusters. We identified 146 patients (68 male, 42.9 ± 14.1 years old) with silent PIT1‐lineage PitNETs. Morphology clustering suggested that tumors with large nuclei and apparent eccentricity were associated with a higher proportion of aggressiveness and a higher hazard of recurrence [hazard ratio (HR): 2.64, (95% CI, 1.06-6.55), p = 0.037]. Immunohistochemical clustering suggested that tumors with thyroid stimulating hormone (TSH) staining or all negative PIT1‐lineage hormones were associated with a higher proportion of aggressiveness and a higher risk of recurrence [HR: 12.4, (95% CI, 1.60-93.5), p = 0.015]. We obtained three‐tier risk profiles by combining morphological and immunohistochemical clustering. Patients with the high‐risk profile presented the highest recurrence rate compared with those in the medium‐risk and low‐risk profiles [HR: 3.54, (95% CI, 1.40-8.93), p = 0.002]. In conclusion, digital image analysis based on cell morphology and immunohistochemical staining allows objective stratification of patients with silent PIT1‐lineage tumors. Typical morphological characteristics of high‐risk tumors are large tumor nuclei and high eccentricity, and typical immunostaining characteristics are TSH staining or negative staining for all PIT1‐lineage hormones. 
546 |a EN 
690 |a artificial intelligence 
690 |a pituitary adenoma 
690 |a clustering 
690 |a nonfunctioning 
690 |a Pathology 
690 |a RB1-214 
655 7 |a article  |2 local 
786 0 |n The Journal of Pathology: Clinical Research, Vol 9, Iss 6, Pp 488-497 (2023) 
787 0 |n https://doi.org/10.1002/cjp2.340 
787 0 |n https://doaj.org/toc/2056-4538 
856 4 1 |u https://doaj.org/article/4e9e7b4304b84c23a891cd39b82e0c6b  |z Connect to this object online.