Department of Clinical and Molecular Endocrinology, Tokyo Medical and Dental University Graduate School, Tokyo 113-8519, Japan.
Endocr J. 2012;59(3):221-8. doi: 10.1507/endocrj.ej11-0177. Epub 2011 Dec 27.
There are two main subtypes of GH-producing pituitary adenoma: densely granulated (DG-type) and sparsely granulated (SG-type). Despite the difference in drug responsiveness between the two subtypes, their molecular mechanisms remain unknown. The aim of this study is to evaluate the differential expression of genes related to drug responsiveness between the two subtypes of somatotroph adenoma, and their relationship to the clinical characteristics. Eighty-two acromegaly patients (44 DG-type, 38 SG-type) were studied retrospectively. Clinical characteristics were compared between the two subtypes. Among them, 36 tumor tissue specimens (19 DG-type, 17 SG-type) were available for investigation of the expression of SSTR2, SSTR5 and D2R that are reported to be involved in drug responsiveness by realtime RT-PCR. Protein level was evaluated by immunohistochemical study. Patients with SG-type adenomas were younger in age and showed greater GH suppression by octreotide, but not by bromocriptin, and bigger in size and more invasiveness than DG-type adenomas. The mRNA expression of SSTR2 in DG-type adenomas were greater than those in SG-type adenomas and showed significantly positive correlation with GH suppression by octreotide. There was positive correlation between mRNA and protein levels of SSTR2. These data suggested that the differences of responsiveness to octreotide between DG- and SG-type adenomas are based on the expression levels of SSTR2.
有两种主要的 GH 分泌性垂体腺瘤亚型:致密颗粒型(DG 型)和稀疏颗粒型(SG 型)。尽管这两种亚型对药物的反应存在差异,但它们的分子机制尚不清楚。本研究旨在评估两种生长激素腺瘤亚型之间与药物反应性相关的基因的差异表达,并探讨其与临床特征的关系。回顾性研究了 82 例肢端肥大症患者(44 例 DG 型,38 例 SG 型)。比较了两种亚型的临床特征。其中,36 例肿瘤组织标本(19 例 DG 型,17 例 SG 型)可用于实时 RT-PCR 检测与药物反应性相关的 SSTR2、SSTR5 和 D2R 的表达。通过免疫组织化学研究评估蛋白水平。SG 型腺瘤患者年龄较小,奥曲肽抑制 GH 的效果更好,但溴隐亭抑制 GH 的效果不如奥曲肽,且肿瘤体积较大,侵袭性更强。DG 型腺瘤中 SSTR2 的 mRNA 表达高于 SG 型腺瘤,且与奥曲肽抑制 GH 呈显著正相关。SSTR2 的 mRNA 和蛋白水平之间存在正相关。这些数据表明,DG-和 SG 型腺瘤对奥曲肽反应性的差异基于 SSTR2 的表达水平。