Endocrine Abstracts

Introduction: The duration of hypercortisolism in Cushing’s disease (CD) appears to be inversely related to the reversibility of complications, which in turn increase mortality. This makes it necessary to identify medical therapies capable of normalizing cortisol overproduction before transsphenoidal surgery. The aim of this study was to determine if the clinical data of patients with CD before surgery allow predicting the presence and/or abundance of somatostatin (ssts) and dopamine (DRs) receptors at the corticotrophic adenoma, in order to start a more effective and personalized presurgical medical treatment.

Patients and methods: Retrospective study performed through review of clinical histories and molecular profile analysis of corticotrophic tumors. We included all patients diagnosed with CD (2005–2014) treated with transsphenoidal surgery, and whose tumor sample was analyzed in the Department of Cell Biology, Physiology and Immunology of the University From Córdoba. The correlation study was performed using Spearman’s ρ.

Results: Nine women with CD and molecular profile analysis of corticotrophic tumor. Age 47.33±12 years. A positive correlation was observed between tumor size at diagnosis and levels of receptor expression sst2 [ρ=0.731 (P=0.04)], sst3 [ρ=0.735 (P=0.038)], DR2 [ρ=0.821 (P=0.023)], DR4 [ρ=0.946 (P=0.000)] y DR5 [ρ=0.900 (P=0,037)]. In addition, there was a marked inverse correlation between ACTH levels at diagnosis and the sst5 receptor [ρ=−0.767 (P=0.016)].

Conclusions: Tumor size at the diagnosis of CD seems to show a direct correlation with the levels of expression of sst2 and DR2 receptors, suggesting that in patients with CD with macroadenoma in the initial study, preoperative treatment with somatostatin analogs and/or dopamine may be helpful. In addition, the inverse correlation between ACTH levels at diagnosis and sst5 expression questions whether the specific analogues of this receptor would be useful in the preoperative treatment of CD.