Expression And Significance Of Endocan In Recurrent Pituitary Adenomas

Background: Pituitary adenomas are relatively common benign neoplasms of adenohypophyseal cells, only second to the glioma and meningioma, it is third of the most common intracranial tumor. It often show the symptoms of endocrine and repression, especially the clinical non-functioning adenomas, the tumor has already very huge when patients seek medical advice because of repression symptoms, total excision of the tumor is very difficult, the residual tumor tissues would become the potential risk of recurrence. In the past few decades, many neurosurgeons have already found a variety of factors associated with the risk of recurrence, such as tumor diameter, invasive and whether postoperative radiotherapy, etc. Endocan is a protein polysaccharide that is found in human vascular endothelial cells in recent years, a lot of work has been done around this protein. They found this protein is expressed specially in lung cancer, prostate cancer and breast cancer, etc. It also be expressed in the glioma of the central nervous system. But at present, this protein has not yet been reported that expression in recurrent pituitary.Object: To determine the expression of Endocan in pituitary adenomas by the ways of RT-PCR and immunohistochemical study. And through investigating the relationships between Endocan and factors that ki-67, maximum diameter of tumor, the patient`s age, gender, and tumor recurrence, to study the value and significance of Endocan in the process of occurrence, treatment and prognosis of recurrent pituitary adenomas. Method: Take patients with pituitary adenomas as research object, select age, sex, tumor size, type of hormone and ki-67 protein index as observation target. Through the statistical analysis research the relationship of Endocan and the above indicators, and study the differently expression between the non-recurrence group and the recurrence group.Result: 1. Genetic level: 57 patients with pituitary adenomas were involved in this study, included 8 GH adenomas,5 PRL adenomas,3 GH-PRL adenomas,14 FSH/LH adenomas,4 ACTH adenomas,1 TSH adenoma, 20 null adenomas and 2 plurihormonal adenomas(both were GH-TSH adenomas). Follow-up time is between 20 months to 30 months, 5 patients have relapsed whitin the follow-up time. Endocan expression in patients with different type of hormone have no significant difference. There is no obvious difference between Endocan expression and ptaients age, tumor diameter, and ki-67 index.The value of Endocan expression in female is higher than male, the difference is statistically significant. Endocan expression between the non-recurrence group and the recurrence group has no statistically significant difference.2.Immunohistochemical level: According to the criteria, 16 recurrence pituitary adenomas and 17 non-recurrence pituitary adenomas have been randomly selected. Tumor`s hormone type of immunohistochemical staining are as below: 2 GH adenomas, 2 PRL adenomas, 10 FSH/LH adenomas, 17 null adenomas and 2 plurihormonal adenomas. There is no significance different between the hormone type of pituitary adenomas and tumor diameter. The difference of tumor diameter between recurrent adenomas and non-recurrent adenomas is also not statistically significant. Recurrent and survive, before and after the recurrent, the difference of ki-67 protein index both are statistical significance. Difference of patient`s age between recurrent adenomas and non-recurrent adenomas is statistical significance, and relatively younger patients are more likely to recur. Endocan expression and ki- 67 index has no obvious correlation. Expression of Endocan between recurrent adenomas and non-recurrent adenomas is statistically different.Conclusion: At the immunohistochemical level, Endocan is significantly highly express in recurrent adenomas, but there is no obvious different between recurrent adenomas and non-recurrent adenomas at the genetic level. In addition, Patients' age, sex, tumor diameter and ki- 67 protein expression index have no obvious connection with Endocan expression. The expression of Endocan will play a guilding role for the treatment and prognosis of pituitary adenomas, but the particular function of Endocan in the process of pituitary adenomas and other tumors recurrence still need further study.