{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:58:01Z","timestamp":1791219481709,"version":"4.1.0"},"reference-count":43,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neuroendocrinology"],"abstract":"<jats:p>Introduction: Acromegaly\/gigantism is a rare disease primarily caused by growth hormone (GH)-secreting pituitary neuroendocrine tumors (PitNETs). With the update in the WHO 5th edition classification of pituitary tumors, particularly the introduction of the novel PIT1\/SF1 co-expressing tumor subtype, our understanding of these neoplasms has significantly advanced. However, systematic pathological classification and clinical characterization studies of GH-secreting PitNETs remain relatively scarce. Methods: A retrospective study was conducted on 143 patients with acromegaly\/gigantism who underwent surgical treatment at Peking Union Medical College Hospital between June 2022 and December 2024. Tumor specimens were re-evaluated for pathological subtyping. Demographic data, radiological characteristics, hormone profiles, immunohistochemical findings, and clinical outcomes were collected and compared among subtypes. Results: Forty-five cases (32%) were classified as pure GH-secreting tumors, while the remainder showed co-expression of other hormones and transcription factors. Among PIT1-lineage tumors, sparsely granulated somatotroph tumors (SGSTs) demonstrated greater cavernous sinus invasion, larger maximal tumor diameter, lower GH secretion index, and immunostaining intensity, and reduced SSTR2 expression, suggesting a more aggressive biological behavior. Co-expression of prolactin increased the risk of hyperprolactinemia (OR = 2.843), though only 23.7% of mammosomatotroph tumors and 32.6% of mixed somatotroph-lactotroph tumors presented with hyperprolactinemia. Additionally, 19 PIT1\/SF1 co-expressing tumors were identified, showing diverse hormonal profiles and significantly higher cavernous sinus invasion compared to PIT1-lineage tumors. Conclusion: GH-secreting PitNETs exhibit marked heterogeneity in pathological subtypes. Current classification systems require clearer cutoff criteria to improve diagnostic consistency. SGSTs are associated with a more invasive phenotype, warranting close clinical monitoring and long-term follow-up. PIT1\/SF1 co-expressing tumors represent a distinct and heterogeneous entity that should be considered in future classification frameworks.<\/jats:p>","DOI":"10.1159\/000552989","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T16:01:25Z","timestamp":1782403285000},"page":"1-16","source":"Crossref","is-referenced-by-count":0,"title":["Pathological Classification and Clinical Characteristics of Growth Hormone-Secreting 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