In:
Endocrinology and Metabolism, Korean Endocrine Society, Vol. 36, No. 2 ( 2021-04-30), p. 342-350
Abstract:
Background: The guanine nucleotide-binding protein, alpha stimulating ( 〈 i 〉 GNAS 〈 /i 〉 ) gene has been associated with growth hormone (GH)-secreting pituitary adenoma. We investigated the prevalence of 〈 i 〉 GNAS 〈 /i 〉 mutations in Korean patients with acromegaly and assessed whether mutation status correlated with biochemical or clinical characteristics.Methods: We studied 126 patients with acromegaly who underwent surgery between 2005 and 2014 at Severance Hospital. We performed 〈 i 〉 GNAS 〈 /i 〉 gene analysis and evaluated age, sex, hormone levels, postoperative biochemical remission, and immunohistochemical staining results of the tumor.Results: 〈 i 〉 GNAS 〈 /i 〉 mutations were present in 75 patients (59.5%). Patients with and without 〈 i 〉 GNAS 〈 /i 〉 mutations showed similar age distribution and Knosp classification. The proportion of female patients was 76.5% and 48.0% in the 〈 i 〉 GNAS 〈 /i 〉 -negative and 〈 i 〉 GNAS 〈 /i 〉 -mutation groups, respectively ( 〈 i 〉 P 〈 /i 〉 =0.006). In immunohistochemical staining, the 〈 i 〉 GNAS 〈 /i 〉 -mutation group showed higher GH expression in pituitary tumor tissues than the mutation-negative group (98.7% vs. 92.2%, 〈 i 〉 P 〈 /i 〉 =0.015). Patients with 〈 i 〉 GNAS 〈 /i 〉 mutations had higher preoperative insulin-like growth factor-1 levels (791.3 ng/mL vs. 697.0 ng/mL, 〈 i 〉 P 〈 /i 〉 =0.045) and lower immediate postoperative basal (0.9 ng/mL vs. 1.0 ng/mL, 〈 i 〉 P 〈 /i 〉 =0.191) and nadir GH levels (0.3 ng/mL vs. 0.6 ng/mL, 〈 i 〉 P 〈 /i 〉 =0.012) in oral glucose tolerance tests. Finally, the 〈 i 〉 GNAS 〈 /i 〉 -mutation group showed significantly higher surgical remission rates than the mutation-negative group, both at 1 week and 6 months after surgical resection (70.7% vs. 54.9%, 〈 i 〉 P 〈 /i 〉 =0.011; 85.3% vs. 82.4%, 〈 i 〉 P 〈 /i 〉 =0.007, respectively).Conclusion: 〈 i 〉 GNAS 〈 /i 〉 mutations in GH-secreting pituitary tumors are associated with higher preoperative insulin-like growth factor-1 levels and surgical remission rates and lower immediate postoperative nadir GH levels. Thus, 〈 i 〉 GNAS 〈 /i 〉 mutation status can predict surgical responsiveness in patients with acromegaly.
Type of Medium:
Online Resource
ISSN:
2093-596X
,
2093-5978
DOI:
10.3803/EnM.2020.875
Language:
English
Publisher:
Korean Endocrine Society
Publication Date:
2021
detail.hit.zdb_id:
2802452-7
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