Comparison of ACTH Secretion in Cushing's Adenoma and Clinically Silent Corticotroph Adenoma by Cell Immunoblot Assay.

  • KOJIMA YASUHIRO
    Department of Neurosurgery, Yokohama City University School of Medicine
  • SUZUKI SHINICHI
    Department of Neurosurgery, Yokohama City University School of Medicine
  • YAMAMURA KOJI
    Department of Neurosurgery, Yokohama City University School of Medicine
  • OHHASHI GENICHIRO
    Department of Neurosurgery, Jikei University School of Medicine
  • YAMAMOTO ISAO
    Department of Neurosurgery, Yokohama City University School of Medicine

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抄録

Immunocytochemical staining and cell immunoblot assay (CIBA) were performed in adenoma tissue from five patients with Cushing's disease and three patients with clinically silent corticotroph adenomas. All five patients with Cushing's disease showed hypersecretion of ACTH (130, 190, 331, 120, and 130 pg/ml), high levels of serum cortisol (26.6-44.0 μg/dl), and symptoms of Cushing's disease. All three patients with silent corticotroph adenoma showed hypersecretion of ACTH (110, 140, and 160 pg/ml) and normal levels of serum cortisol (11.4-26.8 μg/dl). The size of the pituitary adenoma on magnetic resonance imaging was smaller in patients with Cushing's disease (mean 8.2 mm) than in patients with silent corticotroph adenoma (mean 26.7 mm) (p=0.001). Transsphenoidal surgery was performed to totally resect the adenoma tissue. Immunostaining for ACTH showed diffuse ACTH-immunopositive cells in all eight adenomas. CIBA technique showed a good correlation between percentage of ACTH-immunopositive cells and level of plasma ACTH in patients with Cushing's disease but no correlation between the two parameters in patients with silent corticotroph adenoma. The percentage of ACTH-secreting cells and the amount of hormone secreted by a single cell are too low in silent corticotroph adenomas to cause an increase in plasma ACTH level corresponding to the large tumor size.

収録刊行物

  • Endocrine Journal

    Endocrine Journal 49 (3), 285-292, 2002

    一般社団法人 日本内分泌学会

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