Analysis of Cortisol Secretion in Hormonally Inactive Adrenocortical Incidentalomas: Study of in vitro Steroid Secretion and Immunohistochemical Localization of Steroidogenic Enzymes.

DOI Web Site PubMed 被引用文献5件 参考文献22件
  • MIDORIKAWA SANAE
    Third Department of Internal Medicine, Fukushima Medical University School of Medicine
  • SANADA HIRONOBU
    Third Department of Internal Medicine, Fukushima Medical University School of Medicine
  • HASHIMOTO SHIGEATSU
    Third Department of Internal Medicine, Fukushima Medical University School of Medicine
  • SUZUKI TAKASHI
    Department of Pathology, Tohoku University School of Medicine
  • WATANABE TSUYOSHI
    Third Department of Internal Medicine, Fukushima Medical University School of Medicine
  • SASANO HIRONOBU
    Department of Pathology, Tohoku University School of Medicine

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タイトル別名
  • Study of <i>in vitro</i> Steroid Secretion and Immunohistochemical Localization of Steroidogenic Enzymes

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Adrenal incidentalomas have recently increased in incidence, and thus it has become important to establish clinical management of these patients. It is also important to evaluate whether these tumors are different from preclinical or overt Cushing's syndrome in their steroidogenesis. In this study, we therefore examined steroidogenesis of hormonally inactive adrenal incidentalomas via short-term culture of tumor specimens, in addition to animmunohistochemical study of steroidogenic enzymes. Five patients (two men and three women) diagnosed with adrenocortical incidentaloma without any clinical signs of adrenocortical hormonal excess except for hypertension and disturbed glucose tolerance, were recruited for this study. Hormonal findings, including circadian rhythms for cortisol and ACTH secretion, the response of ACTH to CRH infusion and results of dexamethasone suppression test were all within normal limits in these patients. Immunoreactivity for all steroidogenic enzymes involved in cortisol production was detected in tumor cells in all cases examined. Results of in vitro steroidogenesis analysis using short-term culture revealed that levels of cortisol secretion varied among the cases. There were no differences in the immunolocalization of steroidogenic enzymes and/or the levels of cortisol secretion between these hormonally inactive tumors and preclinical and/or overt Cushing's syndrome. Dehydroepiandrosterone-sulfotransferase (DHEA-ST) immunoreactivity in nonneoplastic regions was suppressed in one case in which the tumor secreted cortisol similar to preclinical and/or overt Cushing's syndrome. These results demonstrate that the levels of in vitro steroid production and/or the immunolocalization of steroidogenic enzymes in hormonally inactive drenocortical tumors vary markedly and are not overtly different from those of preclinical and/or overt Cushing's syndrome.

収録刊行物

  • Endocrine Journal

    Endocrine Journal 48 (2), 167-174, 2001

    一般社団法人 日本内分泌学会

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