Analysis of the expression levels of DLK1 and MEG3 before and after resection in patients with POU1F1- lineage pituitary tumors and their correlation with prognosis
10.3760/cma.j.cn115396-20250218-00035
- VernacularTitle:POU1F1谱系垂体瘤患者切除术前后 DLK1及 MEG3表达水平及与预后的相关性分析
- Author:
Siwei MA
1
;
Wei DONG
Author Information
1. 唐山市人民医院神经外科，唐山 063000
- Keywords:
Pituitary neoplasms;
Prognosis;
POU class 1 homeobox 1 lineage pituitary tumor;
Delta like non-canonical notch ligand 1;
Maternally expressed gene 3
- From:
International Journal of Surgery
2025;52(4):275-283
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the specific expressions of Delta like non-canonical Notch ligand 1 ( DLK1) and Maternally expressed gene 3 ( MEG3) in POU class 1 homeobox 1 (POU1F1) spectrum pituitary tumors and their correlation with prognosis. Methods:A retrospective case-control study method was adopted. A total of 167 patients with POU1F1 lineage pituitary adenomas who were diagnosed and underwent pituitary adenoma resection at Tangshan People′s Hospital from April 2021 to April 2023 were collected as the research subjects. There were 98 males and 69 females with an average age of (63.05±7.51) years, ranging from 52 to 82 years. They were divided into good prognosis group ( n=111) and poor prognosis group ( n=56) according to postoperative follow-up. A multiple linear regression analysis was performed to examine the relationships between the levels of DLK1 mRNA and MEG3 mRNA and the immune function indicators (Complement 3/Complement 4/Immunoglobulin M/Immunoglobulin A). Multivariate Logistic regression analysis was used to investigate the correlation between DLK1 mRNA and MEG3 mRNA levels and poor prognosis of patients. The odds ratio (OR) of multivariate Logistic regression analysis was calculated. RCS model was used to analyze the dose-response relationship between DLK1 mRNA and MEG3 mRNA and poor prognosis of pituitary tumor resection in POU1F1 spectrum patients. The measurement data following a normal distribution were presented as mean±standard deviation ( ± s), and the t-test was used for comparison between groups. The count data were presented as the number of cases and percentages (%), and the chi-square test was used for comparison between groups. Results:Before treatment, the levels of DLK1 mRNA and MEG3 mRNA in the serum of patients in the good prognosis group were 0.142±0.047 and 0.075±0.024 respectively, and after treatment, they were 0.019±0.003 and 0.577±0.067 respectively. Before treatment, the levels of DLK1 mRNA and MEG3 mRNA in the serum of patients in the poor prognosis group were 0.109±0.035 and 0.067±0.016 respectively, and after treatment, they were 0.057±0.011 and 0.298±0.047 respectively. Before and after treatment the level of DLK1 mRNA in the good prognosis group was significantly lower than that in the poor prognosis group, and the level of MEG3 mRNA in the good prognosis group was significantly higher than that in the poor prognosis group ( P< 0.05). Moreover, the serum DLK1 mRNA and MEG3 mRNA of patients after treatment were significantly different from those before treatment ( P<0.05). The levels of adrenocorticotropin (ACTH), growth hormone, prolactin, complement 3, mean visual field defect and weighted visual field index in the good prognosis group were (42.15±4.68) ng/L, (13.47±2.17) ng/L, (8.28±1.76) ng/L, (1.38±0.34) g/L, (5.26±1.15) dB, (89.14±17.23)%. In the poor prognosis group, there were (56.64±6.42) ng/L, (18.06±3.11) ng/L, (11.49±2.93) ng/L, (1.12±0.45) g/L and (7.96±1.52) dB, (73.65±15.28)%, and there was statistical significance in the above indexes between the two groups ( P< 0.05). There was no independent correlation between the expression of DLK1 mRNA and MEG3 mRNA and immune function indexes (Complement 3/Complement 4、IgM、IgA) ( P>0.05). There was an independent positive correlation between high level of DLK1 mRNA and poor prognosis ( OR=0.521, 95% CI: 0.466-0.738), and a stable correlation between low level of MEG3 mRNA and poor prognosis ( OR=0.761, 95% CI: 0.526-0.883). There is a negative nonlinear dose-response relationship between MEG3 and risk of poor prognosis, and a positive nonlinear dose-response relationship between DLK1 and risk-poor prognosis. The area under ROC curve (AUC) of DLK1 mRNA and MEG3 mRNA for predicting poor prognosis were 0.685(0.504-0.797) and 0.710 (0.611-0.806), respectively. Conclusion:There are significant differences between serum DLK1 mRNA and MEG3 mRNA after treatment and before treatment. DLK1 mRNA were positively nonlinear independent correlated with poor prognosis, and MEG3 mRNA was negatively nonlinear independent correlated with poor prognosis.
