Disentangling secretory ambiguity and the limitations of classical thresholds in defining prolactinomas
Authors' conclusion
Rigid biochemical thresholds fail to capture the full spectrum of lactotroph adenoma biology. Significant secretory ambiguity exists for macroadenomas below 200 ng/mL, creating risk of misclassification.
Study context
- Population
- Patients undergoing first-time surgery for pituitary adenomas; patients with clinical or biochemical evidence of ACTH- or GH-secreting tumors excluded
- Participants
- 425 patients
- Exposure
- Prolactinomas vs non-functional pituitary adenomas (NFPAs)
- Lactotroph adenomasn = 115
- NFPAsn = 291reference
- Mammosomatotrophsn = 19
- Outcome
- PSE-based group separation and diagnostic accuracy of the 200 ng/mL prolactin threshold (PSE = serum prolactin-to-tumor volume ratio)
Methodological detailspathology-informed
- Pathology-informed
Main finding
As reported in the abstract
Prolactin within diagnostic grey zone (ULN < prolactin < 200 ng/mL)
Observational data: associations, not effects.
Original publication
Disentangling secretory ambiguity and the limitations of classical thresholds in defining prolactinomas. Pituitary. Published 23 July 2026. doi:10.
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