Effects From Preoperative Interventions Of Different Drugs On The Proliferation Indexes Of Human GH-secreting Pituitary Adenomas

Object:To study the influences of different preoperative treatments on proliferation index of pituitary adenoma tumor (Mib-1 and TopoⅡα) in groups, which would provide instructions for the best treatments of acromegaly.Methods:To collect 362 cases of diagnosed acromegaly during 2002-2010 from Kopfklinik of Nurnberg-Erlangen University. Using immunohistochemical staining method to show the positive tumor cells that express Mib-1 and TopoⅡα, and comprehensive analysis the Labeling indexs with other clinical data statistically.Results:The Labeling indexes of Mib-1 and TopoⅡαare significantly relative to pituitary tumors Hardy classification and invasiveness of tumor(all p=0.000<0.05), and only Mib-1 Labeling index correlated the total resection rate significantly(p=0.000<0.05), both Mib-1 and TopoⅡlabeling indexes have no gender difference (p=0.415,0.861. respectively). Different preoperative drug interventions have significant effects on the labeling indexes of Mib-1 and Topo-2a(p=0.000,0.001, respectively), one of which is Somatostatin analogue (SA), that can effectively reduce the tumor proliferation index(p=0.000). However, Somatostatin analogue contributed not significantly to the tumor proliferation labeling indexes when used along with growth hormone receptor antagonists (p>0.05). Administer of only dopamine agonists, or together with Sandostatin analogue, and administer of Sandostatin analogues together with growth hormone receptor antagonist showed no significant influences on tumor proliferation index(p>0.05).Conclusion:The Labeling indexes of Mib-1 and Topo-2a showed no remarkable differences between male and female patients, but which could be the indicator to estimate tumor invade degree and prognosis. Preoperative administration of Somatostatin analogues helps reducing postoperative recurrence and aggressiveness of tumor. Growth hormone receptor inhibitors may increase the tumor proliferation marks index, which are not suitable for single use but recommended to apply together with STT analogue. Dopamine agonists has no significant influence on tumor proliferation index, but it’s suitable for pituitary adenomas which release GH and also PRL. Radiation therapy can be used as auxiliary method besides surgery and pharmacotherapy.