The Role of T-box Transcription Factor in a Pituitary Adenoma Diagnostic Algorithm

• DOI: 10.5858/arpa.2020-0091-oa
• Publication Date: 2020-09-29T19:58:38Z
• Authors: William C. McDonald; Kelsey N. McDonald; Jordan A. Helmer; Bridget Ho; Amber Wang; Nilanjana Banerji
• Keywords: Corticotropic cell

Context.— We previously examined pituitary adenomas with immunohistochemical (IHC) stains for steroidogenic factor 1, Pit-1, anterior hormones, cytokeratin CAM 5.2, and the α-subunit of human chorionic gonadotropin found that a screening panel comprising adrenocorticotropic hormone successfully classified most cases reduced overall number required. Objectives.— To examine potential role IHC stain T-box transcription (Tpit) in classification our series to update as necessary. Design.— collected 157 from 2 institutions included these tissue microarrays. Immunostains Tpit were scored blinded fashion using Allred system. Adenomas assigned gold standard class based on pattern followed by application available clinical serologic information. Test characteristics calculated. Correlation analyses, cluster tree analyses used see whether staining patterns reliably reflected adenoma class. Results.— Of collected, 147 (93.6%) had sufficient material analysis. identified 8 null cell (all nonfunctioning clinically) silent corticotrophs; showed better sensitivity, specificity, positive predictive value, negative value than 5.2. continued show expected relationships among stains. Cluster grouping into clinically consistent groups. Classification analysis underscored central stains, including Tpit, classification. Conclusions.— Substitution improves prior algorithm reducing false-negatives false-positives. As result, fewer are adenoma, more corticotroph adenoma.