{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:13:56Z","timestamp":1792026836663,"version":"4.4.0"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82071996"],"award-info":[{"award-number":["82071996"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82003075"],"award-info":[{"award-number":["82003075"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005089","name":"Natural Science Foundation of Beijing Municipality","doi-asserted-by":"publisher","award":["L246050"],"award-info":[{"award-number":["L246050"]}],"id":[{"id":"10.13039\/501100005089","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005024","name":"Beijing Postdoctoral Science Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Growth hormone\u2010secreting pituitary neuroendocrine tumors (GH\u2010secreting PitNETs) pose significant health risks due to hormone\u2010related complications. Despite transsphenoidal surgical resection being the primary treatment, complete removal is often infeasible due to invasive growth patterns, leading to postoperative tumor residuals and uncertain hormone remission outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 458 patients with GH\u2010secreting PitNETs who underwent surgery at Beijing Tiantan Hospital. Data on preoperative hormone levels, MRI scans, and histopathological features were analyzed. Tumor segmentation, intratumor heterogeneity (ITH) scores, and subcluster clustering based on MRI data were computed using radiomic features, while multivariate analyses determined factors influencing hormone remission. Single\u2010cell data from four GH\u2010type pituitary adenomas were collected from public databases to explore ITH in GH1 gene expression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Postoperative hormone remission was achieved in 61 of 144 patients (42.4%) with residual tumors. Univariate analysis demonstrated that in cases with tumor residuals, preoperative hormone levels, tumor resection rates, residual tumor volume, tumor residual location, residual\u2010tumor proximity to the internal carotid artery, and MRI\u2010based tumor heterogeneity were associated with hormone remission. Among these factors, preoperative hormone levels (10\u201330\u2009ng\/mL vs. \u2264\u200910\u2009ng\/mL: OR: 0.48, 95% CI 0.20\u20131.19,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.115; &gt;\u200930\u2009ng\/mL vs. \u2264\u200910\u2009ng\/mL: OR: 0.13, 95% CI: 0.04\u20130.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), tumor resection rate (OR: 18.29, 95% CI: 2.08\u2013160.97,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009), and tumor heterogeneity as measured by the ITH score (OR: 1.06, 95% CI: 1.00\u20131.12,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042) were independent predictors of hormone remission in cases with residual tumors. Moreover, single\u2010cell data showing highly variable GH1 expression within the same patient reveal ITH in hormone expression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative GH levels, tumor resection rates, and ITH scores independently predict hormone remission in GH\u2010secreting PitNETs with residuals. This will provide intraoperative decision\u2010making guidance on how to achieve the maximum possible hormone remission with residual tumors when complete tumor resection is not feasible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cns.70574","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T10:58:25Z","timestamp":1756119505000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Factors Influencing Hormone Remission in Growth Hormone\u2010Secreting Pituitary Neuroendocrine Tumors With Residual Tumor: A Retrospective Cohort Study"],"prefix":"10.1111","volume":"31","author":[{"given":"Yangyang","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Beijing Tiantan Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Beijing Tiantan Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanbao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Beijing Tiantan Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunchang","family":"Ma","sequence":"additional","affiliation":[{"name":"Beijing Neurosurgical Institute Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guijun","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Beijing Tiantan Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7505-177X","authenticated-orcid":false,"given":"Wang","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Beijing Tiantan Hospital, Capital Medical University  Beijing China"},{"name":"Beijing Neurosurgical Institute Capital Medical University  Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases (NCRC\u2010ND)  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiudong","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Beijing Tiantan Hospital, Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.19699"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-020-01091-7"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0071-6"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000505332"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-16-0553"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-2421"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-2700"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.924589"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2014.21"},{"issue":"6","key":"e_1_2_10_11_1","first-page":"906","article-title":"Endoscopic Endonasal Transsphenoidal Treatment for Acromegaly: 2010 Consensus Criteria for Remission and Predictors of Outcomes","volume":"24","author":"Yildirim A. 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