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...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-11-01
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| Series: | The Journal of Pathology: Clinical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cjp2.340 |
| _version_ | 1827798955829755904 |
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| author | Jiangyan Zhao Chenxing Ji Haixia Cheng Zhen Ye Boyuan Yao Ming Shen Xuefei Shou Xiang Zhou Hongying Ye Zhaoyun Zhang Hong Chen Yongfei Wang Fuchu He Yao Zhao Wei Gong Qilin Zhang Nidan Qiao |
| author_facet | Jiangyan Zhao Chenxing Ji Haixia Cheng Zhen Ye Boyuan Yao Ming Shen Xuefei Shou Xiang Zhou Hongying Ye Zhaoyun Zhang Hong Chen Yongfei Wang Fuchu He Yao Zhao Wei Gong Qilin Zhang Nidan Qiao |
| author_sort | Jiangyan Zhao |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-11T19:43:19Z |
| format | Article |
| id | doaj.art-4e9e7b4304b84c23a891cd39b82e0c6b |
| institution | Directory Open Access Journal |
| issn | 2056-4538 |
| language | English |
| last_indexed | 2024-03-11T19:43:19Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Journal of Pathology: Clinical Research |
| spelling | doaj.art-4e9e7b4304b84c23a891cd39b82e0c6b2023-10-06T05:04:38ZengWileyThe Journal of Pathology: Clinical Research2056-45382023-11-019648849710.1002/cjp2.340Digital image analysis allows objective stratification of patients with silent PIT1‐lineage pituitary neuroendocrine tumorsJiangyan Zhao0Chenxing Ji1Haixia Cheng2Zhen Ye3Boyuan Yao4Ming Shen5Xuefei Shou6Xiang Zhou7Hongying Ye8Zhaoyun Zhang9Hong Chen10Yongfei Wang11Fuchu He12Yao Zhao13Wei Gong14Qilin Zhang15Nidan Qiao16Department of Neurosurgery, Huashan Hospital, Institutes of Biomedical Sciences Fudan University Shanghai PR ChinaDepartment of Neurosurgery, Huashan Hospital, Institutes of Biomedical Sciences Fudan University Shanghai PR ChinaDepartment of Pathology Huashan Hospital Shanghai PR ChinaDepartment of Neurosurgery, Huashan Hospital, Institutes of Biomedical Sciences Fudan University Shanghai PR ChinaFudan University Graduate School Shanghai PR ChinaDepartment of Neurosurgery, Huashan Hospital, Institutes of Biomedical Sciences Fudan University Shanghai PR ChinaDepartment of Neurosurgery, Huashan Hospital, Institutes of Biomedical Sciences Fudan University Shanghai PR ChinaDepartment of Neurosurgery, Huashan Hospital, Institutes of Biomedical Sciences Fudan University Shanghai PR ChinaDepartment of Endocrinology Huashan Hospital Shanghai PR ChinaDepartment of Endocrinology Huashan Hospital Shanghai PR ChinaDepartment of Pathology Huashan Hospital Shanghai PR ChinaDepartment of Neurosurgery, Huashan Hospital, Institutes of Biomedical Sciences Fudan University Shanghai PR ChinaDepartment of Neurosurgery, Huashan Hospital, Institutes of Biomedical Sciences Fudan University Shanghai PR ChinaDepartment of Neurosurgery, Huashan Hospital, Institutes of Biomedical Sciences Fudan University Shanghai PR ChinaDepartment of Endocrinology Huashan Hospital Shanghai PR ChinaDepartment of Neurosurgery, Huashan Hospital, Institutes of Biomedical Sciences Fudan University Shanghai PR ChinaDepartment of Neurosurgery, Huashan Hospital, Institutes of Biomedical Sciences Fudan University Shanghai PR ChinaAbstract 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.https://doi.org/10.1002/cjp2.340artificial intelligencepituitary adenomaclusteringnonfunctioning |
| spellingShingle | Jiangyan Zhao Chenxing Ji Haixia Cheng Zhen Ye Boyuan Yao Ming Shen Xuefei Shou Xiang Zhou Hongying Ye Zhaoyun Zhang Hong Chen Yongfei Wang Fuchu He Yao Zhao Wei Gong Qilin Zhang Nidan Qiao Digital image analysis allows objective stratification of patients with silent PIT1‐lineage pituitary neuroendocrine tumors The Journal of Pathology: Clinical Research artificial intelligence pituitary adenoma clustering nonfunctioning |
| title | Digital image analysis allows objective stratification of patients with silent PIT1‐lineage pituitary neuroendocrine tumors |
| title_full | Digital image analysis allows objective stratification of patients with silent PIT1‐lineage pituitary neuroendocrine tumors |
| title_fullStr | Digital image analysis allows objective stratification of patients with silent PIT1‐lineage pituitary neuroendocrine tumors |
| title_full_unstemmed | Digital image analysis allows objective stratification of patients with silent PIT1‐lineage pituitary neuroendocrine tumors |
| title_short | Digital image analysis allows objective stratification of patients with silent PIT1‐lineage pituitary neuroendocrine tumors |
| title_sort | digital image analysis allows objective stratification of patients with silent pit1 lineage pituitary neuroendocrine tumors |
| topic | artificial intelligence pituitary adenoma clustering nonfunctioning |
| url | https://doi.org/10.1002/cjp2.340 |
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