垂体GH腺瘤GH分泌生化特征及与gsp癌基因表达相关性

Growth hormone secretion and biochemical characteristics of somatotrophinoma and the association with gsp oncogene

目的探讨生长抑素对人垂体生长激素腺瘤生长激素(GH)分泌的效应及其与gsp癌基因的表达相关性。方法收集20例GH腺瘤患者体内注射长效生长抑素(SST)后GH和胰岛素样生长因子-1(IGF-1)的变化,术中切除肿瘤组织进行体外细胞培养后分为SST组和对照组,应用酶联免疫吸附试验(ELISA)检测药物干预后GH的分泌变化。同时提取肿瘤组织DNA检测gsp基因序列。结果在20例肿瘤标本中10例gsp癌基因突变阳性(50%)。SST干预后体内外GH分泌大多受到不同程度抑制,个别表现出刺激效应,但与gsp癌基因表达无统计学相关性。结论短期使用SST对大多数GH腺瘤患者体内和体外均有抑制GH水平作用,少数患者具有天然耐药性。

Objective The expression of gsp oncogene in human somatotrophinomas and their correlation with effects of somatostatin analogs （ SST） on growth hormone （ GH） secretion were discussed. Methods The changes of GH and insulin-like growth factor 1 （ IGF-1 ） pre-and post-SST treatment in patients with GH-secreting adenomas were analyzed.Tumor tissue samples were collected for in vitro culture and then all the samples were divided into SST group and control group.ELISA was used to detect the GH changes after the SST treatment.Genome DNA of each sample was extracted for gsp gene sequencing. Results Among these 20 cases, gsp oncogene mutation was found in 10 cases （50%）.Somatostatin could inhibit GH secretion both in vivo and in vitro in most of the cases.However, there was no statistical correlation between the level of inhibition and the expression of gsp oncogene.Conclusion Short-term administration of somatostatin indicates a certain down-regulation of serum GH levels and GH-secretion in vitro.Nevertheless, a few patients exhibit nature resistance to SST treatment.