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Thus, they are one of the most frequent diagnoses in neuropathologist's practise. 2022 5th edition WHO Classification of Endocrine and Neuroendocrine Tumors does not support a grading and\/or staging system for PitNETs and argues that histological typing and subtyping are more robust than proliferation rate and invasiveness to stratify tumors. Numerous studies suggest the existence of clinically relevant molecular subgroups encouraging an integrated histo\u2010molecular approach to the diagnosis of PitNETs to deepen the understanding of their biology and overcome the unresolved problem of grading system. The present review illustrates the main issues involved in establishing a grading and a staging system, as well as alternative systems validated by independent series to date. The state of art of the current histological and molecular markers is detailed, demonstrating that a standardized and reproducible clinico\u2010pathological approach, combined with the integration of molecular data may help build a workflow to refine the definition of PitNETs with \u2018malignant potential\u2019 and most importantly, avoid delay in patient treatment. Next molecular studied are needed to validate an integrated histo\u2010molecular grading for PitNETs.<\/jats:p>","DOI":"10.1111\/bpa.13299","type":"journal-article","created":{"date-parts":[[2024,8,25]],"date-time":"2024-08-25T20:57:59Z","timestamp":1724619479000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Grading and staging for pituitary neuroendocrine tumors"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6245-4487","authenticated-orcid":false,"given":"Chiara","family":"Villa","sequence":"first","affiliation":[{"name":"Department of Neuropathology, H\u00f4pital Universitaire Piti\u00e9\u2010Salp\u00eatri\u00e8re, APHP Sorbonne Universit\u00e9  Paris France"},{"name":"Inserm U1016, CNRS UMR 8104, Institut Cochin Universit\u00e9 Paris Descartes\u2010Universit\u00e9 de Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Francesca","family":"Birtolo","sequence":"additional","affiliation":[{"name":"Inserm U1016, CNRS UMR 8104, Institut Cochin Universit\u00e9 Paris Descartes\u2010Universit\u00e9 de Paris  Paris France"},{"name":"Department of Biomedical Sciences Humanitas University  Milan Italy"},{"name":"Endocrinology, Diabetology and Medical Andrology Unit IRCCS Humanitas Research Hospital  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Gustavo","family":"Perez\u2010Rivas","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik IV, LMU Klinikum LMU M\u00fcnchen  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Righi","sequence":"additional","affiliation":[{"name":"Department of Pathology IRCCS Istituto Ortopedico Rizzoli  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Assie","sequence":"additional","affiliation":[{"name":"Inserm U1016, CNRS UMR 8104, Institut Cochin Universit\u00e9 Paris Descartes\u2010Universit\u00e9 de Paris  Paris France"},{"name":"Department of Endocrinology, Center for Rare Adrenal Diseases H\u00f4pital Cochin APHP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Baussart","sequence":"additional","affiliation":[{"name":"Inserm U1016, CNRS UMR 8104, Institut Cochin Universit\u00e9 Paris Descartes\u2010Universit\u00e9 de Paris  Paris France"},{"name":"Department of Neurosurgery, H\u00f4pital Universitaire Piti\u00e9\u2010Salp\u00eatri\u00e8re, APHP Sorbonne Universit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Asioli","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM), Bellaria Hospital, AUSL Bologna University of Bologna  Bologna Italy"},{"name":"Pituitary Neurosurgery Program, Pituitary Unit IRCCS istituto delle Scienze Neurologiche  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noad149"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2020.04.002"},{"key":"e_1_2_10_4_1","unstructured":"Central Nervous System Tumours WHO Classification of Tumours 5th ed. 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