Abstract
Acromegaly is a rare disease caused by overproduction of growth hormone (GH) by a pituitary adenoma, and consequently increased insulin-like growth factor 1 (IGF-1) concentration. The GH/IGF-1 axis and immune cells interactions are hypothesized to be involved in subclinical inflammation. This retrospective study aimed to investigate the differences in neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR) ratios, and systemic immune-inflammation index (SII) in GH-secreting adenomas compared with non-functioning pituitary adenomas (NFPAs) concerning clinical and radiological findings. After evaluation of 665 patients with pituitary tumors, 62 individuals with newly diagnosed acromegaly and 134 with NFPAs were enrolled in the analysis. The control group consisted of 120 healthy individuals. Fifty-eight patients with acromegaly were re-evaluated after medical or surgical therapies. NLR, PLR, SII values, and neutrophil count were significantly higher (p ≤ 0.001), whereas lymphocyte count was lower in acromegaly than in NFPAs (p = 0.001). No significant differences between NFPAs and controls were observed in analyzed ratios. Higher preoperative NLR, PLR, SII values were found in patients who failed to achieve a cure with surgery (p < 0.05). Although NLR, PLR, and SII values were significantly higher in acromegaly, these indices cannot be used to discriminate GH-secreting pituitary tumors from NFPAs. Treatment of acromegaly decreased the value of NLR and SII, but it requires further studies to consolidate the real clinical role of these inflammation-related ratios.
Highlights
Is a rare chronic disease caused by excessive production of growth hormone (GH), mostly by a pituitary adenoma, and subsequent insulin-like growth factor1 (IGF-1) excess [1]
neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) values were significantly higher in acromegaly than in non-functioning pituitary adenomas (NFPAs), these inflammatory indices cannot be used to discriminate GH-secreting pituitary tumors from NFPAs due to very low diagnostic accuracy
The results of our study indicate that complete blood count (CBC)-derived parameters differ significantly in patients with acromegaly as compared with NFPAs and healthy individuals
Summary
Is a rare chronic disease caused by excessive production of growth hormone (GH), mostly by a pituitary adenoma, and subsequent insulin-like growth factor1 (IGF-1) excess [1]. Is a rare chronic disease caused by excessive production of growth hormone (GH), mostly by a pituitary adenoma, and subsequent insulin-like growth factor. The clinical features of acromegaly may be very subtle, which most likely results in a prolonged diagnostic delay of an average of 5 to 10 years after the onset of first signs and symptoms [4]. Recent studies have proved that local and systemic inflammation may modulate and promote several tumorigenic processes, such as tumor cell proliferation, migration, invasion, angiogenesis, and immune cell chemoattraction in different cancers [6,7]. Findings from clinical and basic research studies have strongly indicated the importance of supraphysiological doses of GH and IGF-1 in initiating the inflammatory process via cytokine production by immune cells [5,8]. T-cells, B-cells, and monocytes are concerned to play a crucial role in the bi-directional communication network between the endocrine and immune systems in patients with acromegaly [9,10]
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