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Low somatostatin receptor subtype 2, but not dopamine receptor subtype 2 expression predicts the lack of biochemical response of somatotropinomas to treatment with somatostatin analogs
Ist Teil von
Journal of endocrinological investigation, 2013, Vol.36 (1), p.38-43
Ort / Verlag
Cham: Springer International Publishing
Erscheinungsjahr
2013
Quelle
MEDLINE
Beschreibungen/Notizen
Objectives:
To evaluate somatostatin receptor 2A (SSTR2A) and dopamine receptor 2 (DR2) protein expression in somatotropinomas and to relate it to response to somatostatin analogues (SA).
Design and patients:
SSTR2A and DR2 expression was analyzed by immunohistochemistry in 88 somatotropinomas from patients submitted to either pre-surgical or adjuvant SA treatment. Tumors were scored according to percentage of immunostained cells: 0 (<25%), 1 (25–50%), and 2 (>50%). Relation between protein expression and response to SA was performed in 66 patients. Response to SA was assessed by percent IGF-I reduction, being considered as an IGF-I per cent reduction higher than 50%. Disease control was also assessed (GH<1.0 ng/ml and normal IGF-I).
Results:
SSTR2A and DR2 were expressed in 100% and 98% of tumors, respectively. Biochemical response and disease control rates were 48% and 32%, respectively. Median IGF-I percent reduction after 3 months of SA treatment was lower in the SSTR2A score 0 than in the scores 1 and 2 (
p
<0.001, both), and after 6 months in the score 0 than in the score 1 (
p
=0.001) and 2 (
p
<0.001). Biochemical response and disease control were associated with SSTR2 expression (
p
<0.001 and
p
=0.004, respectively). A negative predictive value for biochemical response of 100% was found when a SSTR2A expression <25% of immunostained cells cut-off point was considered. No relation was found between DR2 expression and biochemical response and disease control.
Conclusion:
SSTR2A and DR2 are highly expressed in somatotropinomas. Low SSTR2A, but not DR2, expression is a negative predictive factor to response to SA.