Endocrine Abstracts

Introduction: Although pituitary adenomas are considered benign, some have invasive growth, which is one indicator of aggressiveness. Early prognostic markers of aggressiveness may influence the quality of life improvement in patients with aggressive pituitary adenomas

Objectives: To study the clinical-immunological, molecular-genetic aspects of aggressive pituitary adenomas and to develop new approaches to early diagnosis and treatment.

Materials and methods: 83 patients diagnosed with pituitary adenoma were examined. All patients underwent clinical examination and magnetic resonance imaging (MRI), to determine the degree of adenoma invasion by Knops classification. Polymorphism of regions of studied genes in the VEGFA gene of position G634C (rs2010963 locus), the gene HIF-1α C/T (rs11549465 locus) and G-197A in the gene IL-17A, made by the allele method - determined by the PCR method.

Results: Genetic analysis of VEGFA polymorphism showed that heterozygote (G/C) mutation in patients with invasive adenomas was found to be twice as high as 32.7% (n=17.2) compared to a control group of 15.7% (n=13). Moreover, the C/C homozygote mutation is also observed more in the 7.7% invasive adenoma patient group (n=4), which supports the evidence that mechanistic progression of invasive adenomas contributes to angiogenesis mutation through the VEGFA pathway. A heterozygous C/T mutation of the HIF-1A gene was found to be significantly higher (P=0.02) in patients with invasive adenomas compared to controls, with 25% (n=13) and 9.8% (n=8), respectively. While in non-invasive adenomas, this mutation was observed about three times lower. Our results clearly support the argument for the regulatory role of HIF-1A within VEGFA in the development of aggressive pituitary adenoma flow.

Conclusions: Thus, genetic analysis can become a predictor of aggressive behavior of pituitary adenomas and the use of genetic markers in clinical practice will contribute to the prevention of complications of aggressive adenomas.