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Figure 1 3.1 Proliferation markers Most PRLomas present low proliferative activity determined by the Ki-67 proliferative index ( 3.2 Estrogen and progesterone signaling pathways Several studies support the role of estrogens and their receptors (ERs) in PRLomas development and progression ( In men, PRL-secreting PAs express lower levels of ER than in women ( Some studies also indicate progesterone involvement in PRLomas development ( 3.3 Growth factors Among the growth factors involved in the regulation of the pituitary function, particular attention to PRLomas development is paid to the transforming growth factor-beta1 (TGF1) due to its involvement in lactotroph physiology