Clinical Characteristics and Therapeutic Responses in Patients with Germ-Line AIP Mutations and Pituitary Adenomas: An International Collaborative Study

被引:269
作者
Daly, Adrian F. [1 ]
Tichomirowa, Maria A. [1 ]
Petrossians, Patrick [1 ]
Heliovaara, Elina [3 ,4 ]
Jaffrain-Rea, Marie-Lise [5 ,6 ]
Barlier, Anne [7 ]
Naves, Luciana A. [8 ]
Ebeling, Tapani [9 ]
Karhu, Auli [3 ,4 ]
Raappana, Antti [10 ]
Cazabat, Laure [12 ]
De Menis, Ernesto [13 ]
Fajardo Montanana, Carmen [14 ]
Raverot, Gerald [15 ]
Weil, Robert J. [16 ,17 ]
Sane, Timo [18 ]
Maiter, Dominique [19 ]
Neggers, Sebastian [20 ]
Yaneva, Maria [21 ]
Tabarin, Antoine [22 ]
Verrua, Elisa [23 ]
Eloranta, Eija [9 ]
Murat, Arnaud [24 ]
Vierimaa, Outi [11 ]
Salmela, Pasi I. [9 ]
Emy, Philippe [25 ]
Toledo, Rodrigo A. [26 ]
Isabel Sabate, Maria [27 ]
Villa, Chiara [28 ,29 ,31 ]
Popelier, Marc [32 ]
Salvatori, Roberto [33 ]
Jennings, Juliet [34 ,35 ]
Ferrandez Longas, Angel [36 ]
Labarta Aizpun, Jose Ignacio [36 ]
Georgitsi, Marianthi
Paschke, Ralf [37 ]
Ronchi, Cristina [23 ]
Valimaki, Matti [18 ]
Saloranta, Carola [18 ]
De Herder, Wouter [20 ]
Cozzi, Renato [38 ]
Guitelman, Mirtha
Magri, Flavia [29 ,31 ]
Lagonigro, Maria Stefania [29 ,30 ]
Halaby, Georges [39 ]
Corman, Vinciane [40 ]
Hagelstein, Marie-Therese [2 ]
Vanbellinghen, Jean-Francois [2 ]
Barra, Gustavo Barcelos [41 ]
Gimenez-Roqueplo, Anne-Paule [42 ]
机构
[1] Univ Liege, CHU Liege, Dept Endocrinol, B-4000 Liege, Belgium
[2] Univ Liege, CHU Liege, Dept Mol Genet, B-4000 Liege, Belgium
[3] Univ Helsinki, Biomedicum Helsinki, Mol & Canc Biol Program, FI-00014 Helsinki, Finland
[4] Univ Helsinki, Biomedicum Helsinki, Dept Med Genet, FI-00014 Helsinki, Finland
[5] Univ Aquila, Dept Expt Med, I-86077 Pozzilli, Italy
[6] Ist Ricovero & Cura Carattere Sci, I-86077 Pozzilli, Italy
[7] Univ Mediterranee, Lab Biochem & Mol Biol, CHU Concept,CNRS, Ctr Rech Neurobiol Neurophysiol Marseille,UMR 623, F-13385 Marseille, France
[8] Univ Brasilia, Div Endocrinol, BR-70910 Brasilia, DF, Brazil
[9] Univ Oulu, Dept Med, FIN-90029 Oys, Finland
[10] Univ Oulu, Dept Otorhinolaryngol, FIN-90029 Oys, Finland
[11] Univ Oulu, Dept Clin Genet, FIN-90029 Oys, Finland
[12] Univ Paris 05, INSERM, U567,Fac Med, Dept Endocrinol Metab & Canc,CNRS,UMR 8104,Inst C, Rene Descartes, France
[13] Osped Gen Montebelluna, I-131044 Montebelluna, Italy
[14] Hosp Univ Ribera, Dept Endocrinol, Valencia 46600, Spain
[15] CHU Lyon, Dept Endocrinol, F-69495 Lyon, France
[16] Cleveland Clin, Brain Tumor Inst, Cleveland, OH 44195 USA
[17] Cleveland Clin, Dept Neurosurg, Cleveland, OH 44195 USA
[18] Univ Helsinki, Cent Hosp, Dept Endocrinol, Helsinki 00029, Finland
[19] Catholic Univ Louvain, Dept Endocrinol, St Luc Univ Hosp, B-1200 Brussels, Belgium
[20] Erasmus MC, Endocrinol Sect, Dept Internal Med, NL-3015 GD Rotterdam, Netherlands
[21] Med Univ, Clin Ctr Endocrinol & Gerontol, Sofia 1431, Bulgaria
[22] CHU Bordeaux, Dept Endocrinol, Hop Haut Leveque, F-33600 Pessac, France
[23] Osped Maggiore Policlin Mangiagalli Regina Elena, Unit Endocrinol, Fdn Inst Ricovero & Cura Carattere Sci, I-20122 Milan, Italy
[24] CHU Nantes, Dept Endocrinol, F-44093 Nantes, France
[25] Ctr Hosp Reg, Dept Endocrinol, F-45032 Orleans, France
[26] Univ Sao Paulo, Unidade Endocrinol Genet, Lab Invest Med 25, Div Endocrinol,Hosp Clin,Fac Med, BR-05403900 Sao Paulo, Brazil
[27] Austral Univ Hosp, RA-1629 Buenos Aires, DF, Argentina
[28] Univ Paris 05, Dept Neuropathol & Neurosurg, CH St Anne, INSERM,U984, F-75014 Paris, France
[29] Univ Pavia, Unit Internal Med & Endocrinol, Fdn Salvatore Maugeri, Inst Ricovero & Cura Carattere Sci, I-27100 Pavia, Italy
[30] Univ Pavia, Ist Super Prevenz & Sicurezza, Lavoro Lab Endocrine Disruptors, I-27100 Pavia, Italy
[31] Univ Pavia, Dept Endocrinol, I-27100 Pavia, Italy
[32] Ctr Hosp, Dept Endocrinol, Serv Med A, F-78514 Rambouillet, France
[33] Johns Hopkins Univ, Div Endocrinol, Sch Med, Baltimore, MD 21287 USA
[34] Royal Childrens Hosp, Murdoch Childrens Res Inst, Dept Endocrinol & Diabet, Parkville, Vic 3052, Australia
[35] Royal Childrens Hosp, Murdoch Childrens Res Inst, Ctr Hormone Res, Parkville, Vic 3052, Australia
[36] Hosp Infantil Miguel Servet, Dept Pediat, Zaragoza 50009, Spain
[37] Univ Leipzig, Dept Med 3, D-04103 Leipzig, Germany
[38] Osped Niguarda Ca Granda, Div Endocrinol, I-20162 Milan, Italy
[39] Hop Hotel Dieu, Dept Endocrinol & Metab, Beirut 166830, Lebanon
[40] Ctr Hospitalier Reg Citadelle, Dept Endocrinol, B-4000 Liege, Belgium
[41] Lab Sabin, BR-8000 Brasilia, DF, Brazil
[42] Univ Paris 05, Dept Genet, Hop Europeen Georges Pompidou, AP HP,INSERM,U770, Paris, France
[43] Greenlane Clin Ctr, Dept Endocrinol, Auckland 1051, New Zealand
[44] Max Planck Inst Psychiat, Dept Endocrinol, D-80804 Munich, Germany
[45] Hop La Timone, Serv Endocrinol Diabet & Malad Metab, F-13385 Marseille, France
[46] Hop La Timone, Ctr Reference Malad Rares Origine Hypophysaires, F-13385 Marseille, France
[47] Hop Bicetre, AP HP, Dept Endocrinol & Reprod Dis, F-94276 Le Kremlin Bicetre, France
[48] Univ Paris 11, F-94276 Le Kremlin Bicetre, France
基金
芬兰科学院;
关键词
RECEPTOR-INTERACTING-PROTEIN; GENE; EXPRESSION; GIGANTISM; PREVALENCE; DEBULKING; FEATURES; TYPE-1; AHR;
D O I
10.1210/jc.2009-2556
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context: AIP mutations (AIPmut) give rise to a pituitary adenoma predisposition that occurs in familial isolated pituitary adenomas and less often in sporadic cases. The clinical and therapeutic features of AIPmut-associated pituitary adenomas have not been studied comprehensively. Objective: The objective of the study was to assess clinical/therapeutic characteristics of AIPmut pituitary adenomas. Design: This study was an international, multicenter, retrospective case collection/database analysis. Setting: The study was conducted at 36 tertiary referral endocrine and clinical genetics departments. Patients: Patients included 96 patients with germline AIPmut and pituitary adenomas and 232 matched AIPmut-negative acromegaly controls. Results: The AIPmut population was predominantly young and male (63.5%); first symptoms occurred as children/adolescents in 50%. At diagnosis, most tumors were macroadenomas (93.3%); extension and invasion was common. Somatotropinomas comprised 78.1% of the cohort; there were also prolactinomas (n = 13), nonsecreting adenomas (n = 7), and a TSH-secreting adenoma. AIPmut somatotropinomas were larger (P = 0.00026), with higher GH levels (P = 0.00068), more frequent extension (P = 0.018) and prolactin cosecretion (P = 0.00023), and occurred 2 decades before controls (P < 0.000001). Gigantism was more common in the AIPmut group (P < 0.000001). AIPmut somatotropinoma patients underwent more surgical interventions (P = 0.00069) and had lower decreases in GH (P = 0.00037) and IGF-I (P = 0.028) and less tumor shrinkage with somatostatin analogs (P < 0.00001) vs. controls. AIPmut prolactinomas occurred generally in young males and frequently required surgery or radiotherapy. Conclusions: AIPmut pituitary adenomas have clinical features that may negatively impact treatment efficacy. Predisposition for aggressive disease in young patients, often in a familial setting, suggests that earlier diagnosis of AIPmut pituitary adenomas may have clinical utility. (J Clin Endocrinol Metab 95: E373-E383, 2010)
引用
收藏
页码:E373 / E383
页数:11
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