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垂体瘤——可能的靶向治疗展望。

Pituicytoma-An outlook on possible targeted therapies.

机构信息

Department of Neurosurgery, Hamburg University Medical Center, Hamburg, Germany.

Institute of Neuropathology, Hamburg University Medical Center, Hamburg, Germany.

出版信息

CNS Neurosci Ther. 2017 Jul;23(7):620-626. doi: 10.1111/cns.12709. Epub 2017 May 28.

Abstract

INTRODUCTION

Pituicytoma is a rare neoplasm of the sella region. Tumor resection is the primary treatment option, but remains subtotal due to excessive bleeding in many cases. The search for alternative or additional treatment regimens is necessary.

AIMS

We aimed to determine the receptor expression of pituicytoma to find alternatives or supplements to surgical therapy in the use of targeted therapies.

METHODS

Pituicytoma samples were collected from three institutions between 2006 and 2015 and were stained for vascular endothelial growth factors (VEGF), thyroid transcription factor (TTF1), and somatostatin receptors (SSTR 2/3/5). The stains were classified from 0=no staining to +++=strong staining. A complementary retrospective analysis of the patient charts regarding sex, age, and primary symptoms, pituitary function, and perioperative complications was performed.

RESULTS

Ten samples were analyzed; mean patient age was 57.8 years SD 16.3 years. Seven samples were acquired from male patients (one relapse) and three from female. All tumors stained strongly positive (+++) for VEGF-R. Six samples stained positive for TTF1. As for somatostatin receptors, three samples were slightly positive for SSTR 2; seven were negative. SSTR 3 was + in one, three were ++, three were +++, and three were 0. SSTR 5 stained +++ in 1, ++ in 5, + in 1, and 0 in three patients.

CONCLUSIONS

Pituicytomas were generally positive for VEGFR and showed regular expression of SSTR 3 and 5 indicating a possible treatment option through targeted therapies in cases where resection remains insufficient. Further research is necessary as to whether tumor growth can be inhibited using these pathways.

摘要

简介

垂体细胞瘤是鞍区罕见的肿瘤。肿瘤切除术是主要的治疗选择,但由于术中出血过多,许多情况下只能进行次全切除。因此,需要寻找替代或额外的治疗方案。

目的

我们旨在确定垂体细胞瘤的受体表达情况,以寻找替代手术治疗的方法,或为使用靶向治疗提供补充。

方法

本研究收集了 2006 年至 2015 年间三家机构的垂体细胞瘤样本,并对血管内皮生长因子(VEGF)、甲状腺转录因子(TTF1)和生长抑素受体(SSTR 2/3/5)进行染色。染色从 0(无染色)到 +++(强染色)进行分类。对患者的性别、年龄、首发症状、垂体功能和围手术期并发症等病历进行了回顾性分析。

结果

分析了 10 例样本;患者平均年龄为 57.8 岁(标准差为 16.3 岁)。其中 7 例为男性(1 例复发),3 例为女性。所有肿瘤均强烈(+++)表达 VEGF-R。6 例样本 TTF1 染色阳性。至于生长抑素受体,3 例 SSTR 2 弱阳性,7 例阴性。SSTR 3 在 1 例中为+,3 例为++,3 例为+++,3 例为 0。SSTR 5 在 1 例中+++,5 例中++,1 例中+,3 例中 0。

结论

垂体细胞瘤通常对 VEGFR 呈阳性反应,并显示出 SSTR 3 和 5 的规律表达,这表明在切除不充分的情况下,通过靶向治疗可能是一种治疗选择。需要进一步研究这些途径是否可以抑制肿瘤生长。

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