Association of serum biomarkers, immunohistochemical profiles, and preoperative clinical manifestations in patients undergoing endoscopic endonasal resection of pituitary neuroendocrine tumors
摘要
This study examined the correlation between clinical presentation, serum biomarkers, and immunohistochemical markers in patients with pituitary neuroendocrine tumors (PitNETs). This study aimed to evaluate the associations between preoperative clinical presentation, serum hormone levels, and IHC findings, and to describe postoperative endocrine outcomes in a surgically treated cohort. A cross-sectional analysis was conducted on sixty-five patients who underwent endonasal endoscopic surgery between 2015 and 2023 at our institution. Clinical data were retrospectively analyzed, and Spearman correlation coefficients, logistic regression, and ROC curves were used to assess associations. All patients exhibited some degree of visual dysfunction, while 72.3% reported headaches and 44.6% had hypothyroidism. A strong correlation was found between serum gonadal dysfunction and erectile dysfunction in males (φ = 0.59). Most other serum abnormalities displayed weak correlations with symptoms. Histological marker positivity showed moderate correlations between LH and FSH hormones with erectile dysfunction (φ = 0.43), while TSH had weaker associations with erectile dysfunction (φ = 0.28) and with vomiting (φ = 0.25). Most hormonal abnormalities showed minimal correlations with IHC markers, except for a moderate correlation between prolactin IHC positivity and hyperprolactinemia (φ = 0.36), followed by weaker correlations between GH IHC positivity and GH serum levels (φ = 0.22), and between ACTH IHC positivity and serum cortisol levels (φ = 0.11). Overall, immunohistochemical markers exhibited weak correlations with clinical manifestations, except for moderate associations of LH and FSH serum levels with erectile dysfunction. Serum markers also showed limited direct relationships with histological findings. Larger studies are needed to validate these correlations and improve their clinical applicability in PitNET treatment.