{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:46:45Z","timestamp":1787014005574,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T00:00:00Z","timestamp":1620604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to establish a preoperative prediction method for sparsely granulated (SG) growth hormone (GH)\u2010secreting pituitary adenoma, an aggressive tumour subtype with high recurrence risk, in acromegaly patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eighty\u2010three patients with GH\u2010secreting pituitary adenomas were included in this study. GH measurements, cytokeratin immunostaining and electron microscopy were performed to detect granulation patterns. Preoperative factors, including general, radiological and endocrinological features and acute octreotide suppression test outcomes, were compared between SG and densely granulated (DG) groups. The predictive capabilities of these features were analysed using a receiver operating characteristic (ROC) curve, and the most predictive features were combined to establish a grading scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010nine of the 83 patients had SG GH\u2010secreting pituitary adenomas; 44 had DG tumours. SG tumours tended to occur in younger patients and have larger diameters and volumes, higher Knosp grades, lower GH indexes and normalized insulin\u2010like growth factor\u20101 (IGF\u20101) level, and a lower \u2206GH% after octreotide treatment. The tumour size, Knosp grade, GH index and \u2206GH% after octreotide treatment had good predictive performance, with area under the curve (AUC) values ranging from 0.70 to 0.80. Combining four parameters, including diameter, Knosp grade, GH index and \u2206GH% after octreotide treatment, we established a grading scale for predicting SG GH\u2010secreting pituitary adenomas with an AUC of 0.84 and relatively high sensitivity and specificity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We propose a predictive method for distinguishing SG and DG GH\u2010secreting pituitary adenomas preoperatively. This method will help physicians identify candidates for presurgical medical treatment and neurosurgeons determine radical surgical strategies for high\u2010risk tumours.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.14465","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T03:30:45Z","timestamp":1616124645000},"page":"134-142","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Preoperative prediction of granulation pattern subtypes in GH\u2010secreting pituitary adenomas"],"prefix":"10.1111","volume":"95","author":[{"given":"Lijun","family":"Heng","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Tangdu Hospital Air Force Medical University  Xi\u2019an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pathology Tangdu Hospital Air Force 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