垂体腺瘤是源于前垂体腺体内分泌细胞的肿瘤。大部分情况下，它们是良性肿瘤，但有时会表现出侵袭性，并在某些情况下转移。它们的生物学，包括它们广泛的行为范围，仅在一定程度上被理解。在治疗定位方面，大多数垂体腺瘤可使用可用的医疗治疗、手术和有时的放疗轻松治疗。尽管如此，促性腺激素瘤缺乏医疗治疗选择，并且治疗侵袭性垂体腺瘤和垂体癌仍具有挑战性。在这里，我们概述了肿瘤微环境在垂体腺瘤中的意义，审查了其组成和功能，以及迄今已经使用肿瘤微环境定位治疗处理的案例。此外，我们还讨论了新兴观点，例如非血管生成性肿瘤的概念，并提出了有关可能代表未来潜在治疗选择的治疗前景。肿瘤浸润淋巴细胞、肿瘤相关巨噬细胞、卵泡星形细胞、肿瘤相关成纤维细胞、血管生成以及细胞外基质及其重塑，在垂体腺瘤的生物学中都具有复杂的作用。它们与垂体腺瘤中的激素生产/分泌、大小、侵袭、增殖、进展/复发以及治疗反应等方面有关。从治疗的角度来看，免疫检查点抑制剂和贝伐单抗已在侵袭性垂体腺瘤和垂体癌中显示出一定程度的功效，并且可以预见使用众多其他肿瘤微环境定位治疗。总之，类似于其他癌症，了解肿瘤微环境可以提高我们对垂体腺瘤生物学的理解，超越基因和表观遗传学，并构成开发未来疗法的重要工具。©作者2022年。牛津大学出版社代表内分泌学会发表。保留所有权利。有关许可，请发送电子邮件至：journals.permissions@oup.com。

Pituitary adenomas are neoplasms derived from the endocrine cells of the anterior pituitary gland. Most frequently, they are benign tumors, but may sometimes display an aggressive course, and in some cases metastasize. Their biology, including their wide range of behavior, is only partly understood. In terms of therapeutic targeting, most pituitary adenomas are easily treated with the available medical treatments, surgery, and sometimes radiotherapy. Nevertheless, gonadotroph adenomas lack medical therapeutic options, and treatment of aggressive pituitary adenomas and pituitary carcinomas remains challenging. Here, we present an overview of the implications of tumor microenvironment in pituitary adenomas, reviewing its composition and function, as well as published cases that have been treated thus far using tumor microenvironment-targeting therapies. Additionally, we discuss emerging views, such as the concept of non-angiogenic tumors, and present perspectives regarding treatments that may represent future potential therapeutic options. Tumor-infiltrating lymphocytes, tumor-associated macrophages, folliculostellate cells, tumor-associated fibroblasts, angiogenesis, as well as the extracellular matrix and its remodelling, all have complex roles in the biology of pituitary adenomas. They have been linked to hormone production/secretion, size, invasion, proliferation, progression/recurrence, and treatment response in pituitary adenomas. From a therapeutic perspective, immune-checkpoint inhibitors and bevacizumab have already shown a degree of efficacy in aggressive pituitary adenomas and pituitary carcinomas, and the use of numerous other tumor microenvironment-targeting therapies can be foreseen. In conclusion, similar to other cancers, understanding the tumor microenvironment improves our understanding of pituitary adenoma biology beyond genetics and epigenetics, and constitutes an important tool for developing future therapies.© The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.