Abstract

The increased incidence of accidental revealing adrenal tumors in radiation studies requires further improvement of laboratory diagnostic methods for the timely detection of their latent hormonal activity and malignancy potential, as well as the determination of strategic therapeutic approaches. The aim of the work was to evaluate the capabilities of modern laboratory diagnostics in verification of latent forms of hormone-active adrenal tumors to determine further treatment tactics. The study included 207 (14.9%) of 1390 patients in whom the hormones precursors of steroidogenesis and catecholamine metabolites were studied in blood plasma by liquid chromatography, as well as tumor markers. These patients were divided into a group of subclinical forms of hormone-active NP tumors (n = 173) and a group of truly hormone-inactive formations (n=34). It has been established that pre-aldosteroma is characterized with an increase of corticosterone (8.1±3.4 ng/ml), 11-deoxycorticosterone (12.3±3.0 ng/ml), 18-hydroxycorticosterone (5.4±1,4 ng/ml) in blood. For pre-corticosteroma: increased cortisol (119.2±16.1 ng/ml), 11-deoxycortisol (11.5±1.9 ng/ml), 11-deoxycorticosterone (12.8±2.1 ng/ml), the ratio of cortisol/cortisone (9.1±1.6 ng/ml) in blood. The presence of «silent» pheochromocytoma was confirmed by an increase of blood free methanephrine (105.0±27.1 ng/ml) and normetanephrine (196.0±43.6 ng/ml), as well as chromogranin A (223.3±15.3 pg/ml). The latent forms of adrenocortical cancer were characterized by an increase in blood dehydroepiandrosterone sulfate (45.2±3.9 μmol/L), cancer embryo antigen (9.8±1.2 ng/ml), vascular endothelial growth factor (1122.0±24.5 ng/ml), IL-6 (95.4±1.8 pg/ml), 11-deoxycortisol (21.8±4.5 ng/ml), 11-deoxycorticosterone (4.2±3.2 ng/ml). All 173 patients with hormone-active NP tumors, as well as 30 (88.2%) with large (6.5±2.0 cm) hormone-inactive formations with the presence of compression syndrome, underwent adrenalectomy. Determination of the precursors of steroidogenesis and catecholamine metabolites in blood plasma by liquid chromatography can reliably identify the functional activity of adrenal tumors and determine their malignant potential, as well as substantiate indications for timely surgical treatment.

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.