血浆糖皮质激素和矿化皮质激素作为肾上腺皮质肿瘤早期诊断的标志物

Yu.S. Roienko
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摘要

肾上腺皮质肿瘤是肾上腺皮质细胞生长时形成的。良性肾上腺肿瘤的形态学和组织学结构是多变的,这使其早期诊断复杂化。对肾上腺皮质激素水平的研究以及对疾病症状的分析不仅可以区分产生激素的肿瘤,还可以预测代谢过程的方向,这将使选择正确的治疗方案和防止其他器官的并发症成为可能。本研究的目的是确定不同类型肾上腺皮质腺瘤患者的皮质醇和醛固酮水平,并评估垂体-肾上腺和肾素-醛固酮系统的状态。材料和方法。肾上腺皮质的激素状态是通过使用直接定量酶免疫分析法测定糖皮质激素-皮质醇和矿皮质激素-醛固酮的水平来评估的。采用促肾上腺皮质激素(ACTH)和肾素特异性单克隆抗体,免疫化学法测定促肾上腺皮质激素(ACTH)和肾素水平。研究的结果。在皮质醇产生肾上腺皮质腺瘤患者的ACTH水平下降的背景下,检测到皮质醇水平的增加。我们在醛固酮产生性腺瘤患者中发现的醛固酮增多症是在肾素水平不变和醛固酮/肾素比值升高的背景下发生的。结论。肾上腺皮质激素依赖性腺瘤的发展伴随着垂体-肾上腺和肾素-醛固酮系统工作的失衡,其变化方向可作为肾上腺皮质肾上腺腺瘤早期诊断的标准
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Glucocorticoids and mineralocorticoids in blood plasma as markers of early diagnostic adrenal cortical tumors
Adrenocortical tumours of the adrenal glands are formed when the cells of the cortical layer grow. The morphological and histological structure of benign adrenal tumours is variable, which complicates their early diagnosis. The study of the levels of hormones in the adrenal cortex along with the analysis of the symptoms of the disease will allow not only to differentiate hormone-producing tumours, but also to predict the direction of metabolic processes, which will make it possible to choose the right treatment regimen and prevent complications from other organs. The aim of the study is to determine the level of cortisol and aldosterone and assess the state of the pituitary-adrenal and renin-aldosterone systems in patients with various types of adrenocortical adenomas. Materials and methods. The state of the hormonal status of the adrenal cortex was assessed by determining the level of glucocorticoids - cortisol and mineralocorticoids - aldosterone using a direct quantitative enzyme immunoassay. The level of adrenocorticotropic hormone (ACTH) and renin was determined by immunochemical methods using monoclonal antibodies specific for ACTH and renin. Research results. An increase in the level of cortisol was detected against the background of a decrease in the level of ACTH in patients with cortisol-producing adrenocortical adenomas. It is shown that the aldosteronism we discovered in patients with aldosterone-producing adenomas develops against the background of an unchanged renin level and an increase in the aldosterone/renin ratio. Conclusions. The development of hormone-dependent adenomas of the adrenal cortex is accompanied by an imbalance in the work of the pituitary-adrenal and renin-aldosterone systems, the direction of changes of which can serve as a criterion for early diagnosis of adrenocortical adrenal adenomas
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