Abstract
Pituitary adenomas account for 10–15% of primary intracranial tumors. Growth hormone (GH)-secreting adenomas account for 13% of all pituitary adenomas and cause acromegaly. These tumors can be aggressive, invade surrounding structures and are highly recurrent. The objective of this study was to evaluate E-cadherin, Slug and neural cell adhesion molecule (NCAM) expression in GH-secreting pituitary adenomas and its relationship to tumor invasiveness. A cross–sectional study of patients who underwent hypophysectomy due to GH-secreting pituitary adenoma from April 2007 to December 2014 was carried out. The medical records were reviewed to collect clinical data. Immediately after surgery, tumor samples were frozen in liquid nitrogen and stored in a biofreezer at –80°C for assessment of E-cadherin 1 (CDH1), SLUG (SNAI2), and NCAM (NCAM1) by real-time PCR. The samples were fixed in formalin and embedded in paraffin for immunohistochemical analysis of E-cadherin and NCAM. Thirty-five patients with acromegaly were included in the study. Of these, 65.7% had invasive tumors. Immunohistochemically, E-cadherin was expressed in 96.7% of patients, and NCAM in 80% of patients. There was no statistically significant relationship between tumor grade or invasiveness and immunohistochemical expression of these markers. Regarding gene expression, 50% of cases expressed CDH1, none expressed SNAI2, and 53.3% expressed NCAM1. There was no statistically significant relationship between tumor grade or invasiveness and gene expression of CDH1, SNAI2, and NCAM1. The absence of Slug overexpression and of E-cadherin and NCAM suppression suggests that expression of these markers is not associated with tumor invasiveness in GH-secreting pituitary adenomas.
Highlights
Pituitary adenomas are common tumors, with an estimated prevalence of 16.7%, and autopsy studies have reported their presence in 20 to 25% of cases, accounting for 10 to 15% of primary intracranial tumors [1]
Growth hormone (GH)-secreting pituitary adenomas account for 13% of all pituitary adenomas and lead to acromegaly, a chronic disease characterized by hypersecretion of GH and insulin-like growth factor 1
Patients This cross-sectional study consisted of 35 consecutive patients with a clinical and laboratory diagnosis of acromegaly who underwent neurosurgery performed by a single surgeon (NPF) at Hospital São José, Complexo Hospitalar Santa Casa de Porto Alegre, Southern Brazil, from April 2007 to December 2014
Summary
Pituitary adenomas are common tumors, with an estimated prevalence of 16.7%, and autopsy studies have reported their presence in 20 to 25% of cases, accounting for 10 to 15% of primary intracranial tumors [1]. Growth hormone (GH)-secreting pituitary adenomas account for 13% of all pituitary adenomas and lead to acromegaly, a chronic disease characterized by hypersecretion of GH and insulin-like growth factor 1. The disease has cardiovascular, rheumatologic, respiratory and metabolic consequences. Pituitary adenomas are considered benign tumors, but they may become aggressive and invade surrounding tissues. 60% of patients with adenomas greater than 1 cm (macroadenomas) have tumor recurrence after surgical treatment. The absence of a prognostic classification or consensual prognostic markers limits the evaluation of medical strategies for pituitary tumors
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