Poor correlation of serum alpha-subunit concentration and magnetic resonance imaging following pituitary surgery in patients with nonfunctional pituitary macroadenomas.
Endocr Pract
; 14(4): 452-7, 2008.
Article
em En
| MEDLINE
| ID: mdl-18558599
ABSTRACT
OBJECTIVE:
To review the clinical utility of measuring serum alpha-subunit as a marker for residual tumor in a group of patients with surgically resected nonfunctional pituitary adenomas.METHODS:
In this retrospective cross-sectional chart review using the pituitary database at the Cleveland Clinic, we identified patients with nonfunctional pituitary macroadenomas over a 4-year period (2000-2004) and selected those patients who had an elevated alpha-subunit concentration measured before pituitary surgery. Presurgery and post-surgery measurements of alpha-subunit, luteinizing hormone, follicle-stimulating hormone, and thyroid-stimulating hormone were documented. Findings from preoperative and postoperative pituitary magnetic resonance imaging (MRI) were reviewed.RESULTS:
We identified 54 patients who were evaluated for nonfunctional pituitary macroadenomas during the study period. Of the 39 who underwent pituitary surgery, 34 had a serum alpha-subunit concentration measured before surgery. Eight of 34 patients had elevated preoperative alpha-subunit levels with a median value of 1.8 ng/mL (range, 1.0-3.4 ng/mL). Of the 8 patients, 7 had follow-up MRI a median of 12 months (range, 6-52 months) after surgery. One patient was lost to follow-up. Three of 7 patients had persistently elevated alpha-subunit levels postoperatively; in 2 of these 3, MRI did not identify residual tumor. Among the 4 patients with postoperative normalization of alpha-subunit, 2 patients had residual tumor on MRI.CONCLUSION:
The discrepancy between alpha-subunit levels and postoperative MRI calls into question the value of routine alpha-subunit measurement as a tumor marker in patients with nonfunctional pituitary macroadenomas.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Hipofisárias
/
Imageamento por Ressonância Magnética
/
Subunidade alfa de Hormônios Glicoproteicos
/
Adenoma
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Endocr Pract
Assunto da revista:
ENDOCRINOLOGIA
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Estados Unidos