Purpose To investigate the relationship of Fibroblast Growth Factor Receptor-4 (FGFR-4) expression with radiologic, pathologic, and clinical parameters in pituitary adenomas. Methods Among 307 patients who underwent pituitary surgery for a pituitary adenoma between 2000 and 2015, we included 161 patients (53 gonadotroph, 26 corticotroph, 25 null cell, 22 lactotroph, 13 somatotroph, 8 adenomas with unusual combination, 7 Pit-1 positive adenomas, and 7 lactosomatotroph) based on availability of pathology specimens. Patients’ radiologic, pathologic, and clinical parameters were determined. FGFR-4 immunostaining was evaluated using a semi-quantitative histologic score (H-score). Results The mean follow-up period was 61 (IQR=32–84) months. The median H-scores for FGFR-4 were higher in patients without remission, those with residual lesion, and T2-hyperintense adenoma (p<0.05). Ki-67 level was higher in patients without remission compared to those in remission (p<0.05). The mean Ki-67 levels did not differ between patients with and without residual lesion or T2-hyperintense tumor (p>0.05). There was no significant difference (p>0.05) when the H-score and Ki-67 levels were assessed in terms of sex, sellar-dural invasion, Knosp and a grading system for superior, inferior, parasellar, anterior and posterior tumor extension Classification, tumor function or presence of poor subtype. Adenomas with Ki-67 expression ≥3% had higher FGFR4 expression levels than those with <3% expression (p=0.002). There was a weak positive correlation between H-score and Ki-67 (p=0.011; r=0.201). Conclusions Higher levels of FGFR-4 in pituitary adenomas could be use a marker for more aggressive tumor behavior.

中文翻译：

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垂体腺瘤中成纤维细胞生长因子受体 4 的表达与侵袭性肿瘤特征有关

目的探讨成纤维细胞生长因子受体 4 (FGFR-4) 表达与垂体腺瘤影像学、病理学和临床参数的关系。方法 在 2000 年至 2015 年间因垂体腺瘤接受垂体手术的 307 例患者中，我们纳入了 161 例患者（促性腺激素 53 例、促肾上腺皮质激素 26 例、空细胞 25 例、催乳素细胞 22 例、生长激素细胞 13 例、异常组合腺瘤 8 例、Pit-1 阳性腺瘤 7 例, 和 7 lactosomatotroph) 基于病理标本的可用性。确定了患者的放射学、病理学和临床参数。使用半定量组织学评分（H 评分）评估 FGFR-4 免疫染色。结果平均随访时间为61（IQR=32-84）个月。FGFR-4 的中位 H 评分在没有缓解的患者、有残留病灶的患者中较高，和 T2 高信号腺瘤 (p<0.05)。与缓解患者相比，未缓解患者的 Ki-67 水平较高（p<0.05）。有和没有残留病变或 T2 高信号肿瘤的患者的平均 Ki-67 水平没有差异（p>0.05）。H评分和Ki-67水平在性别、鞍硬膜侵犯、Knosp和上、下、鞍旁、前后肿瘤扩展分类的分级系统方面评估时没有显着差异（p>0.05） ，肿瘤功能或存在较差的亚型。Ki-67 表达≥3% 的腺瘤比表达 <3% 的腺瘤具有更高的 FGFR4 表达水平 (p=0.002)。H-score 与 Ki-67 呈弱正相关（p=0.011；r=0.201）。