PROLACTINOMAS IN MALE AND FEMALE-PATIENTS - A COMPARATIVE CLINICOPATHOLOGICAL STUDY

Objective: To explore the basis of the gender-based differences in end ocrine and surgical findings in patients with prolactinoma (prolactin cell adenoma) as well as in their clinical outcome. Material and Metho ds: In young or reproductive-age female patients, older women (beyond 40 years of age), and male patients, are systematically studied the fo llowing factors: operative and endocrine features (tumor size, invasiv eness, preoperative serum prolactin level, and biochemical outcome), s pecific biologic variables (mitotic index, MIB-1 labeling index, and p 27 immunoreactivity), and hormone receptor status (estrogen and proges terone receptor proteins as well as dopamine D-2 receptor messenger RN A). Results: Of the various factors assessed, the preoperative prolact in level and MIB-1 labeling index were lower in young female patients in comparison with older female and Particularly male patients. Hormon e levels were also positively associated with mitotic activity as well as the MIB-1 labeling index. Although invasion was infrequent in micr oadenomas of young female patients, no statistically significant diffe rences in tumor size or invasiveness were noted among the three patien t groups. Absence of differences in invasiveness may, in part, be expl ained by artifacts of case selection. Conclusion: The basis for the ob served differences in proliferative activities in tumors of the three study groups is not readily apparent but may reflect differences in th e endocrine milieu or the effect of sex steroid hormone receptors, tum oral vascularity, or specific growth factors.