2025 Poster Presentations
P226: EXPLORING THE RELATIONSHIP BETWEEN SERUM MARKERS, IMMUNOHISTOCHEMISTRY MARKERS, AND CLINICAL OUTCOMES FOLLOWING ENDOSCOPIC ENDONASAL RESECTION OF PITUITARY NEUROENDOCRINE TUMORS: INSIGHTS FROM A SINGLE-CENTER EXPERIENCE IN LATIN AMERICA
Edgar G Ordonez-Rubiano, MD, PhDc; Laura F Bonilla-Mendoza, MD; Julian D Barraza-Diaz, MD; Luis E Umana-Laiton, MD, MSc; Oscar F Zorro-Guio, MD; Martin Pinzon, MD; Javier G Patiño-Gomez, MD; Fundacion Universitaria de Ciencias de la Salud
OBJECTIVE: This study aimed to evaluate the correlation between clinical presentation, serum markers, and immunohistochemistry markers as well as their impact on patient's clinical outcomes in patients with pituitary neuroendocrine tumors (PitNETs).
METHODS: This is a cross-sectional study of a prospective series of patients over 18 years old with PitNETs treated surgically with an endonasal endoscopic approach at our institution between January 2015 and October 2023. Clinical data were collected retrospectively from medical records. Spearman correlation coefficients (0 to 1) were used to explore the connections among symptoms, serum markers, and immunochemistry marker positivity. Heat maps were employed to represent correlation matrices for visual clarity and insight. To measure the relationship between variables a logistic regression model was constructed. ROC curves were used to measure the correlation (0 to 1).
RESULTS: A total of 65 patients with PitNETs and complete data available were included. 31 (47.69%) were females. With an average age of 54.48 ± 11.49. All patients (100%) presented with altered visual function, 47 (72.30%) with headaches, 29 (44.61%) with clinical hypothyroidism, and 7 (10.77%) with other cranial nerve impairments. Spearman correlation coefficients demonstrated that serum gonadal dysfunction had a strong correlation with the presence of erectile dysfunction in males (0.62) and diabetes insipidus (DI) had a moderate correlation with polydipsia (0.40). Other serum abnormalities had weak or very weak correlations with the rest of the symptoms. Correlation coefficients between the positivity of histological markers and symptoms demonstrated a moderate positive correlation between histologically positive prolactin (0.17) and positive adrenocorticotropic hormone (ACTH) (0.39) and amenorrhea, a weak positive correlation between histological positive luteinizing hormone and amenorrhea (0.31) and polyuria (0.28). Correlation coefficients between the positivity of histological markers and serum markers demonstrated a moderate positive correlation between histologically positive prolactin and hyperprolactinemia (0.35), a weak positive correlation between growth hormone (0.12), follicle-stimulating hormone (0.1), and ACTH (0.23) with hypercortisolemia. Also, a weak positive correlation between the positivity of thyroid-stimulating hormone (TSH) with hypothyroidism (0.18) and a moderate positive correlation between the positivity of TSH and DI (0.42). The logistic regression model demonstrated an area under the curve (AUC) of 0.6 for headache, 0.8 for endocrine symptoms, 0.7 for vomiting, 0.9 for other cranial nerve impairment, and 0.75 for erectile dysfunction.
CONCLUSIONS: Correlations between immunochemistry markers and symptoms are generally weak. Amenorrhea shows moderate positive correlations with several markers (Prolactin, ACTH, LH, FSH). Other symptoms have weaker correlations, indicating that histological markers alone may not be sufficient to explain variations in symptoms. On the other hand, correlations between serum markers and histological markers are mostly weak, suggesting that serum markers have a limited relationship with histological markers. Larger series are necessary to make stronger correlation studies.
Figure 1. Spearman correlation matrix heat maps. (A) Serum markers vs immunochemistry markers. (B) Immunochemistry markers vs symptoms.
Figure 2. ROC curves. The logistic regression model demonstrated an area under the curve (AUC) of 0.6 for headache, 0.8 for endocrine symptoms, 0.7 for vomiting, 0.9 for other cranial nerve impairment, and 0.75 for erectile dysfunction.
