Revista Clínica Española (English Edition) Revista Clínica Española (English Edition)
Brief Original
Prognostic implications of telomerase expression in pituitary adenomas
Implicación pronóstica de la expresión de telomerasa en adenomas hipofisarios
F. Tortosaa,b,, , S.M. Webbb
a Servicio de Anatomía Patológica, Centro Hospitalar Lisboa Norte, EPE-Hospital de Santa Maria, Lisboa, Portugal
b Departamento de Medicina/Endocrinología, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Unidad 747, Instituto de Salud Carlos III, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
Received 11 July 2017, Accepted 14 December 2017

To analyze the prognostic value of telomerase expression in patients with pituitary adenomas (PAs) followed-up for at least 8 years.

Patients and methods

A retrospective study was conducted of samples from 51 PAs (40 typical and 11 atypical) from patients who underwent transsphenoidal surgery between 2006 and 2008 and from 10 normal pituitary glands obtained by autopsy. Telomerase expression was assessed by immunohistochemistry, correlating the expression with that of Ki-67 and p53.


We observed telomerase expression in 43 PAs (84.3%, 32 of the 40 typical PAs and in the 11 atypical PAs), which was higher in the clinically nonfunctioning cases (p=0.0034) and very rare in the patients with acromegaly (p=0.0001). There was a significant association between the percentage of tumor cells (>10%) and the recurrence of the adenoma (p=0.039). There was no correlation with the expression of Ki-67 and p53 (p=0.4986), and there were no differences according to age, sex, tumor size and invasiveness.


A telomerase expression rate greater than 10% in the pituitary tumor tissue was associated with recurrence or progression of the PA, especially in the nonfunctioning cases.


Analizar el valor pronóstico de la expresión de telomerasa en pacientes con adenomas hipofisarios (AH) seguidos durante al menos 8 años.

Pacientes y métodos

Estudio retrospectivo de las muestras de 51 AH (40 típicos y 11 atípicos) de pacientes sometidos a cirugía transesfenoidal entre 2006 y 2008, y de 10 hipófisis normales obtenidas por autopsia. Se evaluó la expresión de telomerasa por inmunohistoquímica correlacionándola con la de Ki-67 y p53.


Se observó expresión de telomerasa en 43 AH (84,3%, 32 de los 40 típicos y en los 11 atípicos), siendo mayor en los casos clínicamente no funcionantes (p=0,0034) y muy escasa en los pacientes con acromegalia (p=0,0001). Hubo una asociación significativa entre el porcentaje de células tumorales (>10%) y la recurrencia del adenoma (p=0,039). No hubo correlación con la expresión de Ki-67 y p53 (p=0,4986) ni se observaron diferencias en función de la edad, el sexo, el tamaño o la invasividad tumoral.


Un índice de expresión de telomerasa mayor del 10% en el tejido hipofisario tumoral se asoció a recurrencia o progresión del AH, especialmente en los no funcionantes.

Pituitary adenoma, Biomarker, Immunohistochemistry, Telomerase reverse transcriptase
Palabras clave
Adenoma hipofisario, Biomarcador, Inmunohistoquímica, Telomerasa transcriptasa inversa


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