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Background <p>Data on GH and prolactin (PRL) co-secreting pituitary neuroendocrine tumors (GH/PRL-PitNETs), a subtype of acromegaly, remain limited. In particular, comparative analyses of clinical outcomes, including remission rates, between GH/PRL-PitNETs and GH-secreting pituitary neuroendocrine tumors (GH-PitNETs) are scarce.</p> Objective <p>This study aimed to characterize and compare the clinical course and remission outcomes of GH/PRL-PitNETs and GH-PitNETs.</p> Methods <p>We retrospectively analyzed 188 patients with acromegaly who underwent surgery between 2018 and 2024. GH/PRL-PitNETs (<i>n</i> = 46) were compared with GH-PitNETs (<i>n</i> = 142) in terms of their clinical, biochemical, and radiological features. Kaplan–Meier analysis was used to assess differences in biochemical remission between the groups, after which Cox proportional hazards modeling—including a time-dependent treatment variable—was used to identify covariates independently associated with remission.</p> Results <p>GH/PRL-PitNETs were significantly larger and more invasive than GH-PitNETs. The surgical remission rate was lower in the GH/PRL-PitNET group (<i>P</i> = .023). In multivariable Cox analysis, tumor size and cavernous sinus invasion independently predicted inferior outcome in biochemical remission. GH-PitNETs showed a higher incidence of medical comorbidities such as hypertension and thyroid carcinoma.</p> Conclusion <p>GH/PRL-PitNETs demonstrated greater tumor burden and more pronounced structural invasiveness, resulting in a significantly lower likelihood of endocrinological remission.</p>

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Co-secretion of growth hormone and prolactin defines a high-risk acromegaly phenotype

  • 期刊论文

  • 发表日期：

    2026年6月18日

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  • Won Kyu Lee,
  • Hyeong-Cheol Oh,
  • Jin-Kyung Shim,
  • Hyeyeon Oh,
  • So Young Won,
  • Seonah Choi,
  • Yoon-a Hwang,
  • Ju Hyung Moon,
  • Cheol Ryong Ku,
  • Eun Jig Lee,
  • Sun Ho Kim,
  • Eui Hyun Kim

摘要

Background

Data on GH and prolactin (PRL) co-secreting pituitary neuroendocrine tumors (GH/PRL-PitNETs), a subtype of acromegaly, remain limited. In particular, comparative analyses of clinical outcomes, including remission rates, between GH/PRL-PitNETs and GH-secreting pituitary neuroendocrine tumors (GH-PitNETs) are scarce.

Objective

This study aimed to characterize and compare the clinical course and remission outcomes of GH/PRL-PitNETs and GH-PitNETs.

Methods

We retrospectively analyzed 188 patients with acromegaly who underwent surgery between 2018 and 2024. GH/PRL-PitNETs (n = 46) were compared with GH-PitNETs (n = 142) in terms of their clinical, biochemical, and radiological features. Kaplan–Meier analysis was used to assess differences in biochemical remission between the groups, after which Cox proportional hazards modeling—including a time-dependent treatment variable—was used to identify covariates independently associated with remission.

Results

GH/PRL-PitNETs were significantly larger and more invasive than GH-PitNETs. The surgical remission rate was lower in the GH/PRL-PitNET group (P = .023). In multivariable Cox analysis, tumor size and cavernous sinus invasion independently predicted inferior outcome in biochemical remission. GH-PitNETs showed a higher incidence of medical comorbidities such as hypertension and thyroid carcinoma.

Conclusion

GH/PRL-PitNETs demonstrated greater tumor burden and more pronounced structural invasiveness, resulting in a significantly lower likelihood of endocrinological remission.