By contrast, another study that examined tissues from 66 patients with pituitary adenoma reported that although both endothelial and tumor cells expressed ESM-1, ESM-1 expression was significantly higher in tumor cells than in endothelial cells, indicating that the biosynthesis and secretion of ESM-1 may mainly be from tumor cells in pituitary adenoma [14]. This evidence concerns the gene ESM1 and neoplasm.