Predictors of postoperative biochemical remission in lower Knosp grade growth hormone-secreting pituitary adenomas: a large single center study

Zhang, S; Chen, J; Yao, Shun; Akter, Farhana; Wang, Z; Hu, Bin; Zhu, Dexiang; Duan, Chuanwei; Chen, W; Zhu, Yiping; Wang, Haitao; Mao, Zhigang

doi:10.1007/s40618-022-01873-9

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…In addition, the postoperative long-term biochemical remission rates of patients in both groups were improved, and they were still significantly lower in the invasive group (38.5%) than in the noninvasive group (80.6%). The latter was slightly lower than the 68.6% longterm response rate in another recent study of PitNETs with low Knosp grade (0-2), which may be related to the fact that more patients with Knosp grade 2 were included in that study (25%) than in this study (18%) [38]. They also revealed that early postoperative GH levels can be used as predictors of remission and that remission was not associated with preoperative somatostatin analogue therapy, which was basically consistent with our results.…”

Section: Discussioncontrasting

confidence: 75%

Clinical and Proteomic-Based Molecular Characterizations of Invasive and Noninvasive Somatotroph PitNETs

Chen¹,

Duan²,

Sun³

et al. 2023

Neuroendocrinology

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Introduction Somatotroph pituitary neuroendocrine tumours (PitNETs) are characterized by complex and variable biological behaviours with unpredictable patterns of growth and invasiveness. The molecular mechanisms and reliable predictors of biological markers of invasiveness remain unknown. Methods Seventy-two acromegaly patients were consecutively enrolled. Data-independent acquisition (DIA)-based proteomics and Ingenuity Pathway Analysis (IPA) were conducted between invasive and noninvasive somatotroph PitNETs. The expression of selected biomarkers was verified in PitNET tissue, and its correlation with various clinical indicators and outcomes of these tumours was assessed. The invasive phenotypes of GH3 cells were validated in vitro. Results Patients with invasive somatotroph PitNETs were significantly younger at onset and diagnosis, with significantly higher secretion and faster growth and a lower long-term biochemical response rate than patients with noninvasive somatotroph PitNETs. Proteomic data were evaluated in a consecutively collected sample of 19 (10 invasive and 9 noninvasive somatotroph PitNETs) tumours and indicated a distinct proteomic pattern. The enriched and important pathways included IL-4, PDGF, PTEN, VEGF, PI3K/AKT, FAK and other pathways that were significantly associated with tumour proliferation, migration, and invasion. High cathepsin Z (CTSZ) expression was found in invasive somatotroph PitNETs and significantly positively correlated with parameters of tumour invasion and growth. In Ctsz-overexpressing GH3 cells, cell proliferation, invasion and migration were consequently increased. Conclusion It is more difficult for patients with invasive somatotroph PitNETs to achieve remission than those with noninvasive somatotroph PitNETs, and proteomic data analysis has revealed the high expression of CTSZ as a contributing factor to invasive transformation and poor prognosis in somatotroph PitNETs for the first time.

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Section: Discussioncontrasting

confidence: 75%

Clinical and Proteomic-Based Molecular Characterizations of Invasive and Noninvasive Somatotroph PitNETs

Chen¹,

Duan²,

Sun³

et al. 2023

Neuroendocrinology

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Immunological signatures and predictive biomarkers for first-generation somatostatin receptor ligand resistance in Acromegaly

Luo,

Yu,

Tang

2024

J Neurooncol

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Recurrence in acromegaly: two tertiary centers experience and review of the literature

Cremaschi,

Sala,

Lavezzi

et al. 2024

J Endocrinol Invest

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Background Recurrence of acromegaly after successful surgery is a rare event, but no clear data are reported in the literature about its recurrence rates. This study aimed to evaluate the recurrence rate in a series of acromegalic patients treated by transsphenoidal surgery (TSS) with a long follow-up. Methods We retrospectively analyzed data from 283 acromegalic patients who underwent TSS at two pituitary units in Milan (Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico and IRCCS Humanitas Research Hospital). The diagnosis and recurrence of acromegaly were defined by both elevated IGF-1 levels and a lack of GH suppression based on appropriate criteria for the assay used at the time of diagnosis. Results After surgery, 143 patients (50%) were defined as not cured, 132 (47%) as cured and 8 (3%) as partially cured because of normalization of only one parameter, either IGF1 or GH. In the cured group, at the last follow-up (median time 86.8 months after surgery), only 1 patient (0.7%) showed full recurrence (IGF-1 + 5.61 SDS, GH nadir 1.27 µg/l), while 4 patients (3%) showed only increased IGF1. In the partially cured group at the last follow-up, 2/8 (25%) patients showed active acromegaly (IGF-1 SDS + 2.75 and + 3.62; GH nadir 0.6 and 0.5 µg/l, respectively). Conclusions In the literature, recurrence rates range widely, from 0 to 18%. In our series, recurrence occurred in 3.7% of patients, and in fewer than 1%, recurrence occurred with elevation of both IGF-1 and the GH nadir. More frequently (25%), recurrence came in the form of incomplete normalization of either IGF-1 or GH after surgery.

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Predictors of postoperative biochemical remission in lower Knosp grade growth hormone-secreting pituitary adenomas: a large single center study

Cited by 3 publications

References 31 publications

Clinical and Proteomic-Based Molecular Characterizations of Invasive and Noninvasive Somatotroph PitNETs

Clinical and Proteomic-Based Molecular Characterizations of Invasive and Noninvasive Somatotroph PitNETs

Immunological signatures and predictive biomarkers for first-generation somatostatin receptor ligand resistance in Acromegaly

Recurrence in acromegaly: two tertiary centers experience and review of the literature

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