The influence of treatment with somatostatin analogues on morphology, proliferative and apoptotic activity in GH-secreting pituitary adenomas.

With the aim to investigate histopathological changes and proliferative and apoptotic activity in GH-secreting adenomas we compared 14 cases pre-treated with somatostatin analogues before surgery with a reference group of 17 un-pretreated ones. Besides routine histology, immunocytochemical detection of all pituitary hormones, caspase-3, cytokeratin-18, and "M30 antigen", its apoptosis-specific fragment was performed. Proliferation activity of the tumour was determined by the Ki-67 antigen expression. In treated adenomas more prominent regressive changes were found accompanied by compensatory increase in perivascular fibrosis. The Ki-67 labelling index was lower in treated group (mean 2.5, median 1.6 per mille) than in untreated patients (mean 9.4, median 5.0 per mille). The difference was statistically significant (p=0.049 using Mann-Whitney Rank Sum Test). Apoptosis was detected in only 2 of the 14 pre-treated adenomas, and it was more frequent (9/17) and more prominent in the untreated group.