Kurosaki Masamichi, Saegert Wolfgang, Abe Takumi, Lüdecke Dieter K
Department of Neurosurgery, Institute of Neurological Sciences, Tottori University Faculty of Medicine, Yonago, Japan.
Neurol Res. 2008 Jun;30(5):518-22. doi: 10.1179/174313208X289499.
The present study was designed to investigate the localization of VEGF in GH-secreting pituitary adenomas and to evaluate the characteristic differences of VEGF expression in relation to the clinical effect of preoperative treatment with octreotide.
Fifty-six cases of GH-secreting adenomas, which were divided into three groups and three normal pituitary glands, were studied using immunohistochemistry for expression of VEGF. The octreotide group consisted of 33 patients who received the octreotide before the surgery. The bromocriptine group consisted of 11 patients who received bromocriptine orally. The control groups consisted of 12 patients who were not treated with octreotide or bromocriptine pre-operatively. VEGF staining patterns for each specimen were examined under light microscopy and graded in a scale. These findings were correlated with clinical characteristics.
VEGF was displayed in a diffuse cytoplasmic pattern in all cases. VEGF staining was strongly seen in the cytoplasm in normal pituitary glands. Moderately positive staining with VEGF appeared in six of 33 (18%) cases of the octreotide group, and in eight of 12 (67%) cases of the control group. In contrast, weakly positive staining was observed in 25 of 33 (76%) cases of the octreotide group, and in three of 12 (25%) cases of the control group. The staining pattern differs statistically between the octreotide and control group, typically in densely granulated GH cell adenomas. Weak staining with VEGF appeared in all ten cases in which the tumor had shrunk. Age, gender, tumor size, tumor invasiveness and adenoma type did not influence VEGF expression.
We conclude that octreotide may inhibit the angiogenesis through down-regulation of VEGF.
本研究旨在探讨血管内皮生长因子（VEGF）在生长激素分泌型垂体腺瘤中的定位，并评估VEGF表达的特征差异与术前使用奥曲肽治疗临床效果的关系。
采用免疫组织化学法研究56例生长激素分泌型腺瘤（分为三组）及三个正常垂体组织中VEGF的表达情况。奥曲肽组由33例术前接受奥曲肽治疗的患者组成。溴隐亭组由11例口服溴隐亭的患者组成。对照组由12例术前未接受奥曲肽或溴隐亭治疗的患者组成。在光学显微镜下检查每个标本的VEGF染色模式并进行评分。将这些结果与临床特征相关联。
所有病例中VEGF均呈弥漫性胞质模式显示。正常垂体组织的细胞质中可见强烈的VEGF染色。奥曲肽组33例中有6例（18%）VEGF染色呈中度阳性，对照组12例中有8例（67%）呈中度阳性。相比之下，奥曲肽组33例中有25例（76%）呈弱阳性，对照组12例中有3例（25%）呈弱阳性。奥曲肽组和对照组之间的染色模式在统计学上存在差异，在密集颗粒型生长激素细胞腺瘤中尤为明显。肿瘤缩小的所有10例病例中VEGF均呈弱染色。年龄、性别、肿瘤大小、肿瘤侵袭性和腺瘤类型均不影响VEGF表达。
我们得出结论，奥曲肽可能通过下调VEGF来抑制血管生成。
