Pituitary adenomas are heterogeneous, rare tumors, which hinders analysis of large numbers of cases with common approaches. To overcome this, a multicenter, clinical-basic strategy was proposed aimed at enhancing the tools to diagnose and manage pituitary tumors by combining clinical/pathological/molecular information. This initiative was developed by the Sociedad Andaluza de Endocrinología y Nutrición, and further endorsed by the Sociedad Española de Endocrinología y Nutrición, and supported by Novartis. A comprehensive strategy based on a coordinated network was designed covering all Spanish reference centers for pituitary pathology. To develop a shared database registering clinical, pathological and molecular information for each patient and minimize intercenter variability, common protocols and methods were set up for tissue collection, clinical, pathological and molecular data analysis and registry. This joint initiative, named Spanish molecular registry of pituitary adenomas (REMAH) was established in 2010 and organized in six regional nodes. A common database has been generated (http://www.remahnacional.com) including clinical and pathological information. A standardized system for adenoma molecular phenotyping was developed and validated. Specifically, 26 genes were evaluated by quantitative real-time PCR, including pituitary hormones, receptors for somatostatin, dopamine, GHRH, GnRH, CRH, vasopressin and ghrelin, plus additional selected markers (Ki-67, PTTG-1) and three housekeeping genes for normalization (β actin, HPRT, and GAPDH). Molecular information was obtained on 250 tumors, out of 634 patients registered until 2012. Initial analysis indicates a close parallelism of the molecular profile of the adenoma subtypes with previously reported data and with the clinical phenotype of the patients, and also provide additional information on specific receptors known as drug-targets. REMAH is a unique, country-wise, multi-centric, multi-disciplinary network of expertise supported on a shared database enabling a translational, more powerful approach to the management of pituitary adenomas, paving the way for innovative clinical-basic studies with large numbers of patients of these rare pathologies.
27 Apr - 01 May 2013
European Society of Endocrinology