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The characteristics of acromegalic patients with hyperprolactinemia and the differences with hyperprolactinemia
Cheng Huan1, Guihua Cui2, Zongming Ren3
1Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan, PR China.
Abstract:
A substantial proportion of acromegalic patients have co-existent hyperprolactinaemia. To compare this group of population (AC+HPRL) to those of patients with merely hyperprolactinemia (HPRL), a retrospective analysis of patients was conducted. Data regarding clinical and immunohistochemical features, and outcome for patients were reviewed throughout the follow-up period. Four hundred and twenty-three patients were enrolled, with 329 in patients with HPRL and 94 in patients with AC+HPRL. Patients in the AC+HPRL group had a younger age at diagnosis (38.13 ± 13.31 vs. 41.95 ± 14.70 years; p=0.025) and a higher rate of invasion (p=0.007) than those in the HPRL group. The AC+HPRL group had higher GH levels but relatively lower PRL levels than the HPRL group before and after surgery. The rates of positive staining for GH and PRL in HPRL group were 15.20% and 93.01%, and the rates in AC+HPRL group were 84.04% and 87.23%. Patients with HPRL had a lower recurrence rate compared with patients in AC+HPRL group (p=0.018). Additionally, there were no significant correlations between the mean degree of preoperative GH or PRL and the positive rates of immunostaining (p>0.05, p>0.05). The Ki-67 indexes in HPRL group and AC+HPRL group were 3.07% ± 2.13 and 2.33% ± 1.71, respectively (p=0.001). In conclusion, acromegalic patients with hyperprolactinemia need careful and long-term follow-up following an operation.
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