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ISSN (Print): 1574-8871
ISSN (Online): 1876-1038

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Research Article

Gender Differences in Patients with Prolactinoma: Single-center Ukrainian Experience

Author(s): Oleksandr Voznyak*, Iaroslav Zinkevych, Andrii Lytvynenko, Nazarii Hryniv, Roman Ilyuk and Nazarii Kobyliak*

Volume 19, Issue 3, 2024

Published on: 29 March, 2024

Page: [204 - 214] Pages: 11

DOI: 10.2174/0115748871288948240325080936

Price: $65

Abstract

Introduction: Prolactinomas are the most common type of pituitary gland tumors that secrete overly prolactin. They account for approximately 60% of all hormone-secreting hypophysis tumors.

Aim: This study aims to analyze gender differences in patients with prolactinomas who were operated on transsphenoidal surgery and conduct a single-center retrospective analysis of patient data.

Material and Methods: This study evaluated the medical records of 109 patients (61 females and 48 males) from 2009 to 2019 at Feofaniya Clinical Hospital of the State Administration of Affairs in Kyiv, Ukraine. The primary criterion for including patients was a Serum Prolactin (PRL) level of over 100 ng/ml and the presence of a pituitary adenoma (PA) as observed on MRI. Additionally, the histological examination needed to confirm the presence of Prolactin-Secreting Pituitary Adenomas (PSPAs) without plurihormonal activity through both microscopy and immunohistochemical (IHC) staining.

Results: Significant differences in preoperative PRL levels were not observed. However, males had significantly larger tumor sizes and prevalence of macroadenomas. In male patients, the preoperative PLR levels showed a weak negative correlation with age (r=-0.304, p < 0.036) and a positive correlation with tumor size (r=0.555, p < 0.001) and cavernous sinus invasion (r=0.339, p < 0.018). In females, preoperative PRL was significantly associated only with tumor size and Knosp grade.

Conclusion : Prolactin-Secreting Pituitary Adenomas (PSPAs) are more common in women than men and are characterized by larger and more invasive tumors with high PRL levels at diagnosis. The PRL level and tumor size before surgery can predict early biochemical remission in both males and females with an accuracy of 58.3% and 68.8%, respectively.

Keywords: Prolactinomas, dopamine agonists, prolactin, pituitary adenomas, trans-sphenoidal surgery, tumor.

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Graphical Abstract

[1]
Chanson P, Maiter D. The epidemiology, diagnosis and treatment of Prolactinomas: The old and the new. Best Pract Res Clin Endocrinol Metab 2019; 33(2): 101290.
[http://dx.doi.org/10.1016/j.beem.2019.101290] [PMID: 31326373]
[2]
Ciccarelli A, Daly AF, Beckers A. The epidemiology of prolactinomas. Pituitary 2005; 8(1): 3-6.
[http://dx.doi.org/10.1007/s11102-005-5079-0] [PMID: 16411062]
[3]
Zielinski G, Ozdarski M, Maksymowicz M, Szamotulska K, Witek P. Prolactinomas: Prognostic factors of early remission after transsphenoidal surgery. Front Endocrinol 2020; 11: 439.
[http://dx.doi.org/10.3389/fendo.2020.00439] [PMID: 32733387]
[4]
Daly AF, Tichomirowa MA, Beckers A. The epidemiology and genetics of pituitary adenomas. Best Pract Res Clin Endocrinol Metab 2009; 23(5): 543-54.
[http://dx.doi.org/10.1016/j.beem.2009.05.008] [PMID: 19945022]
[5]
Molitch ME. Pituitary incidentalomas. Best Pract Res Clin Endocrinol Metab 2009; 23(5): 667-75.
[http://dx.doi.org/10.1016/j.beem.2009.05.001] [PMID: 19945030]
[6]
Gillam MP, Molitch ME, Lombardi G, Colao A. Advances in the treatment of prolactinomas. Endocr Rev 2006; 27(5): 485-534.
[http://dx.doi.org/10.1210/er.2005-9998] [PMID: 16705142]
[7]
Voznyak O, Zinkevych I, Lytvynenko A, Hryniv N, Ilyuk R, Kobyliak N. Prognostic factors for surgical treatment of prolactin-secreting pituitary adenomas. Front Surg 2024; 11: 1283179.
[http://dx.doi.org/10.3389/fsurg.2024.1283179] [PMID: 38375408]
[8]
Yoo F, Chan C, Kuan E, Bergsneider M, Wang M. Comparison of male and female prolactinoma patients requiring surgical intervention. J Neurol Surg B Skull Base 2018; 79(4): 394-400.
[http://dx.doi.org/10.1055/s-0037-1615748] [PMID: 30009121]
[9]
Melmed S, Kaiser UB, Lopes MB, et al. Clinical biology of the pituitary adenoma. Endocr Rev 2022; 43(6): 1003-37.
[http://dx.doi.org/10.1210/endrev/bnac010] [PMID: 35395078]
[10]
Delgrange E, Sassolas G, Perrin G, Jan M, Trouillas J. Clinical and histological correlations in prolactinomas, with special reference to bromocriptine resistance. Acta Neurochir 2005; 147(7): 751-8.
[http://dx.doi.org/10.1007/s00701-005-0498-2] [PMID: 15971099]
[11]
Castinetti F, Albarel F, Amodru V, et al. The risks of medical treatment of prolactinoma. Ann Endocrinol 2021; 82(1): 15-9.
[http://dx.doi.org/10.1016/j.ando.2020.12.008] [PMID: 33373604]
[12]
Lu J, Cai L, Wu Z, et al. Surgery and medical treatment in microprolactinoma: A systematic review and meta-analysis. Int J Endocrinol 2021; 2021: 1-11.
[http://dx.doi.org/10.1155/2021/9930059] [PMID: 34504526]
[13]
Inder WJ, Jang C. Treatment of prolactinoma. Medicina 2022; 58(8): 1095.
[http://dx.doi.org/10.3390/medicina58081095] [PMID: 36013562]
[14]
Webster J, Piscitelli G, Polli A, Ferrari CI, Ismail I, Scanlon MF. A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea. N Engl J Med 1994; 331(14): 904-9.
[http://dx.doi.org/10.1056/NEJM199410063311403] [PMID: 7915824]
[15]
Fukuhara N, Nishiyama M, Iwasaki Y. Update in pathogenesis, diagnosis, and therapy of prolactinoma. Cancers 2022; 14(15): 3604.
[http://dx.doi.org/10.3390/cancers14153604] [PMID: 35892862]
[16]
Haider SA, Levy S, Rock JP, Craig JR. Prolactinoma. Otolaryngol Clin North Am 2022; 55(2): 305-14.
[http://dx.doi.org/10.1016/j.otc.2021.12.005] [PMID: 35256169]
[17]
Melmed S. Pituitary-tumor endocrinopathies. N Engl J Med 2020; 382(10): 937-50.
[http://dx.doi.org/10.1056/NEJMra1810772] [PMID: 32130815]
[18]
Jackman S, Diamond F. Pituitary adenomas in childhood and adolescence. Pediatr Endocrinol Rev 2013; 10(4): 450-9.
[PMID: 23957196]
[19]
Fideleff HL, Boquete HR, Suárez MG, Azaretzky M. Prolactinoma in children and adolescents. Horm Res Paediatr 2009; 72(4): 197-205.
[http://dx.doi.org/10.1159/000236081] [PMID: 19786791]
[20]
Schaller B. Gender-related differences in prolactinomas. A clinicopathological study. Neuroendocrinol Lett 2005; 26(2): 152-9.
[PMID: 15855888]
[21]
Nishioka H, Haraoka J, Akada K, Azuma S. Gender-related differences in prolactin secretion in pituitary prolactinomas. Neuroradiology 2002; 44(5): 407-10.
[http://dx.doi.org/10.1007/s00234-002-0774-2] [PMID: 12012125]
[22]
Knosp E, Steiner E, Kitz K, Matula C. Pituitary adenomas with invasion of the cavernous sinus space: A magnetic resonance imaging classification compared with surgical findings. Neurosurgery 1993; 33(4): 610-8.
[http://dx.doi.org/10.1227/00006123-199310000-00008] [PMID: 8232800]
[23]
Abou-Al-Shaar H, Mallela AN, Patel A, et al. The role of endoscopic endonasal surgery in the management of prolactinomas based on their invasiveness into the cavernous sinus. Pituitary 2022; 25(3): 508-19.
[http://dx.doi.org/10.1007/s11102-022-01221-3] [PMID: 35467273]
[24]
Amar AP, Couldwell WT, Chen JCT, Weiss MH. Predictive value of serum prolactin levels measured immediately after transsphenoidal surgery. J Neurosurg 2002; 97(2): 307-14.
[http://dx.doi.org/10.3171/jns.2002.97.2.0307] [PMID: 12186458]
[25]
Lopes MBS. The 2017 world health organization classification of tumors of the pituitary gland: A summary. Acta Neuropathol 2017; 134(4): 521-35.
[http://dx.doi.org/10.1007/s00401-017-1769-8] [PMID: 28821944]
[26]
Mykhalchyshyn G, Kobyliak N, Bodnar P. Diagnostic accuracy of acyl-ghrelin and it association with non-alcoholic fatty liver disease in type 2 diabetic patients. J Diabetes Metab Disord 2015; 14(1): 44.
[http://dx.doi.org/10.1186/s40200-015-0170-1] [PMID: 25995986]
[27]
Lamba N, Noormohamed N, Simjian T, et al. Fertility after transsphenoidal surgery in patients with prolactinomas: A meta-analysis. Clin Neurol Neurosurg 2019; 176: 53-60.
[http://dx.doi.org/10.1016/j.clineuro.2018.11.024] [PMID: 30529652]
[28]
Wong A, Eloy JA, Couldwell WT, Liu JK. Update on prolactinomas. Part 1: Clinical manifestations and diagnostic challenges. J Clin Neurosci 2015; 22(10): 1562-7.
[http://dx.doi.org/10.1016/j.jocn.2015.03.058] [PMID: 26256063]
[29]
Berinder K, Stackenäs I, Akre O, Hirschberg AL, Hulting AL. Hyperprolactinaemia in 271 women: Up to three decades of clinical follow-up. Clin Endocrinol (Oxf) 2005; 63(4): 450-5.
[http://dx.doi.org/10.1111/j.1365-2265.2005.02364.x] [PMID: 16181238]
[30]
Lee DY, Oh YK, Yoon BK, Choi D. Prevalence of hyperprolactinemia in adolescents and young women with menstruation-related problems. Am J Obstet Gynecol 2012; 206: 213.
[http://dx.doi.org/10.1016/j.ajog.2011.12.010]
[31]
Souter I, Baltagi LM, Toth TL, Petrozza JC. Prevalence of hyperprolactinemia and abnormal magnetic resonance imaging findings in a population with infertility. Fertil Steril 2010; 94(3): 1159-62.
[http://dx.doi.org/10.1016/j.fertnstert.2009.12.017] [PMID: 20116788]
[32]
Delgrange E, Duprez T, Maiter D. Influence of parasellar extension of macroprolactinomas defined by magnetic resonance imaging on their responsiveness to dopamine agonist therapy. Clin Endocrinol 2006; 64(4): 456-62.
[http://dx.doi.org/10.1111/j.1365-2265.2006.02493.x] [PMID: 16584520]
[33]
Sonigo C, Bouilly J, Carré N, et al. Hyperprolactinemia-induced ovarian acyclicity is reversed by kisspeptin administration. J Clin Invest 2012; 122(10): 3791-5.
[http://dx.doi.org/10.1172/JCI63937] [PMID: 23006326]
[34]
Millar RP, Sonigo C, Anderson RA, et al. Hypothalamic-pituitary-ovarian axis reactivation by kisspeptin-10 in hyperprolactinemic women with chronic amenorrhea. J Endocr Soc 2017; 1(11): 1362-71.
[http://dx.doi.org/10.1210/js.2017-00328] [PMID: 29264460]
[35]
Shimon I, Bronstein MD, Shapiro J, Tsvetov G, Benbassat C, Barkan A. Women with prolactinomas presented at the postmenopausal period. Endocrine 2014; 47(3): 889-94.
[http://dx.doi.org/10.1007/s12020-014-0259-1] [PMID: 24711223]
[36]
Santharam S, Tampourlou M, Arlt W, et al. Prolactinomas diagnosed in the postmenopausal period: Clinical phenotype and outcomes. Clin Endocrinol 2017; 87(5): 508-14.
[http://dx.doi.org/10.1111/cen.13399] [PMID: 28626987]
[37]
Pekić S, Medic Stojanoska M, Popovic V. Hyperprolactinemia/prolactinomas in the postmenopausal period: Challenges in diagnosis and management. Neuroendocrinology 2019; 109(1): 28-33.
[http://dx.doi.org/10.1159/000494725] [PMID: 30347396]
[38]
Nishioka H, Haraoka J, Akada K. Growth potential of prolactinomas in men: Is it really different from women? Surg Neurol 2003; 59(5): 386-90.
[http://dx.doi.org/10.1016/S0090-3019(03)00012-0] [PMID: 12765811]
[39]
Tritos NA, Klibanski A. Eds Prolactin Disorders. Cham: Springer International Publishing 2019.
[http://dx.doi.org/10.1007/978-3-030-11836-5]
[40]
Trouillas J, Delgrange E, Wierinckx A, et al. Clinical, pathological, and molecular factors of aggressiveness in lactotroph tumours. Neuroendocrinology 2019; 109(1): 70-6.
[http://dx.doi.org/10.1159/000499382] [PMID: 30943495]
[41]
Wierinckx A, Delgrange E, Bertolino P, et al. Sex-related differences in lactotroph tumor aggressiveness are associated with a specific gene-expression signature and genome instability. Front Endocrinol 2018; 9: 706.
[http://dx.doi.org/10.3389/fendo.2018.00706] [PMID: 30555413]
[42]
Delgrange E, Trouillas J, Maiter D. Sex-related difference in the growth of prolactinomas: A clinical and proliferation marker study 1. J Clin Endocrinol Metab 1997; 82: 2102-7.
[http://dx.doi.org/10.1210/jcem.82.7.4088] [PMID: 9215279]
[43]
Nishioka H, Ito H, Haraoka J, Hirano A. Growth potential of female prolactinomas. Surg Neurol 2001; 55(4): 213-7.
[http://dx.doi.org/10.1016/S0090-3019(01)00407-4] [PMID: 11358591]
[44]
Molitch ME. Medical treatment of prolactinomas. Endocrinol Metab Clin N Am 1999; 28: 143-69.
[http://dx.doi.org/10.1016/S0889-8529(05)70061-X]

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