Prediction of the transsphenoidal endoscopic adenomectomy results in patients with cushing’s disease
Introduction. Transsphenoidal adenomectomy (TSA) is the method of choice in the treatment of Cushing’s disease (CD), but remission of hypercorticism cannot be achieved in all patients. The search for predictors of CD remission after TSA remains to be an important challenge in the endocrinology today...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
Remedium Group LLC
2022-01-01
|
| Series: | Медицинский совет |
| Subjects: | |
| Online Access: | https://www.med-sovet.pro/jour/article/view/6648 |
| _version_ | 1797841314177351680 |
|---|---|
| author | N. V. Kuritsyna U. A. Tsoy V. Yu. Cherebillo A. A. Paltsev A. I. Tsiberkin E. N. Grineva |
| author_facet | N. V. Kuritsyna U. A. Tsoy V. Yu. Cherebillo A. A. Paltsev A. I. Tsiberkin E. N. Grineva |
| author_sort | N. V. Kuritsyna |
| collection | DOAJ |
| description | Introduction. Transsphenoidal adenomectomy (TSA) is the method of choice in the treatment of Cushing’s disease (CD), but remission of hypercorticism cannot be achieved in all patients. The search for predictors of CD remission after TSA remains to be an important challenge in the endocrinology today.Aim. To study the preoperative and postoperative data of patients with CD to identify the predictors of hypercorticism remission after TSA.Materials and methods. 101 patients with confirmed CD after TSA were included. One year after operation all patients were examined for the presence of hypercorticism remission and divided into two groups: with CD remission and its absence. In both groups’ preoperative pituitary magnetic resonance imaging (MRI) data, the results of preoperative high dose dexamethasone suppression test (HDDST) and the results of serum cortisol collected in the morning 2–3 days after surgery were compared.Results. One year after TSA, CD remission was confirmed in 63 patients (62.4%), whereas in 38 patients (37.6%) hypercortisolism persisted. Favorable predictors of CD remission were: the adenoma size > 3 mm without the invasive growth according to pituitary MRI (specificity 82.4%, sensitivity 82.8%), serum cortisol suppression ≥ 74% in preoperative HDDST (specificity 81.5%, sensitivity 86.3%), morning serum cortisol level in 2–3 days after surgery ≤ 388 nmol/l (specificity 79.3%, sensitivity 97.4%).Conclusions. Pituitary MRI data, the results of preoperative HDDST and morning serum cortisol in the 2–3 days after surgery can be used as predictors of CD remission. |
| first_indexed | 2024-04-09T16:29:03Z |
| format | Article |
| id | doaj.art-cfc8b06e24c64c5badddf828ca41630f |
| institution | Directory Open Access Journal |
| issn | 2079-701X 2658-5790 |
| language | Russian |
| last_indexed | 2024-04-09T16:29:03Z |
| publishDate | 2022-01-01 |
| publisher | Remedium Group LLC |
| record_format | Article |
| series | Медицинский совет |
| spelling | doaj.art-cfc8b06e24c64c5badddf828ca41630f2023-04-23T06:57:11ZrusRemedium Group LLCМедицинский совет2079-701X2658-57902022-01-01021-215216110.21518/2079-701X-2021-21-2-152-1616003Prediction of the transsphenoidal endoscopic adenomectomy results in patients with cushing’s diseaseN. V. Kuritsyna0U. A. Tsoy1V. Yu. Cherebillo2A. A. Paltsev3A. I. Tsiberkin4E. N. Grineva5Almazov National Medical Research CentreAlmazov National Medical Research CentreAlmazov National Medical Research CentreAlmazov National Medical Research CentreAlmazov National Medical Research CentreAlmazov National Medical Research CentreIntroduction. Transsphenoidal adenomectomy (TSA) is the method of choice in the treatment of Cushing’s disease (CD), but remission of hypercorticism cannot be achieved in all patients. The search for predictors of CD remission after TSA remains to be an important challenge in the endocrinology today.Aim. To study the preoperative and postoperative data of patients with CD to identify the predictors of hypercorticism remission after TSA.Materials and methods. 101 patients with confirmed CD after TSA were included. One year after operation all patients were examined for the presence of hypercorticism remission and divided into two groups: with CD remission and its absence. In both groups’ preoperative pituitary magnetic resonance imaging (MRI) data, the results of preoperative high dose dexamethasone suppression test (HDDST) and the results of serum cortisol collected in the morning 2–3 days after surgery were compared.Results. One year after TSA, CD remission was confirmed in 63 patients (62.4%), whereas in 38 patients (37.6%) hypercortisolism persisted. Favorable predictors of CD remission were: the adenoma size > 3 mm without the invasive growth according to pituitary MRI (specificity 82.4%, sensitivity 82.8%), serum cortisol suppression ≥ 74% in preoperative HDDST (specificity 81.5%, sensitivity 86.3%), morning serum cortisol level in 2–3 days after surgery ≤ 388 nmol/l (specificity 79.3%, sensitivity 97.4%).Conclusions. Pituitary MRI data, the results of preoperative HDDST and morning serum cortisol in the 2–3 days after surgery can be used as predictors of CD remission.https://www.med-sovet.pro/jour/article/view/6648hypercorticismremissiontranssphenoidal adenomectomyserum cortisolhigh dose dexamethasone supression testpituitary magnetic resonance imaging |
| spellingShingle | N. V. Kuritsyna U. A. Tsoy V. Yu. Cherebillo A. A. Paltsev A. I. Tsiberkin E. N. Grineva Prediction of the transsphenoidal endoscopic adenomectomy results in patients with cushing’s disease Медицинский совет hypercorticism remission transsphenoidal adenomectomy serum cortisol high dose dexamethasone supression test pituitary magnetic resonance imaging |
| title | Prediction of the transsphenoidal endoscopic adenomectomy results in patients with cushing’s disease |
| title_full | Prediction of the transsphenoidal endoscopic adenomectomy results in patients with cushing’s disease |
| title_fullStr | Prediction of the transsphenoidal endoscopic adenomectomy results in patients with cushing’s disease |
| title_full_unstemmed | Prediction of the transsphenoidal endoscopic adenomectomy results in patients with cushing’s disease |
| title_short | Prediction of the transsphenoidal endoscopic adenomectomy results in patients with cushing’s disease |
| title_sort | prediction of the transsphenoidal endoscopic adenomectomy results in patients with cushing s disease |
| topic | hypercorticism remission transsphenoidal adenomectomy serum cortisol high dose dexamethasone supression test pituitary magnetic resonance imaging |
| url | https://www.med-sovet.pro/jour/article/view/6648 |
| work_keys_str_mv | AT nvkuritsyna predictionofthetranssphenoidalendoscopicadenomectomyresultsinpatientswithcushingsdisease AT uatsoy predictionofthetranssphenoidalendoscopicadenomectomyresultsinpatientswithcushingsdisease AT vyucherebillo predictionofthetranssphenoidalendoscopicadenomectomyresultsinpatientswithcushingsdisease AT aapaltsev predictionofthetranssphenoidalendoscopicadenomectomyresultsinpatientswithcushingsdisease AT aitsiberkin predictionofthetranssphenoidalendoscopicadenomectomyresultsinpatientswithcushingsdisease AT engrineva predictionofthetranssphenoidalendoscopicadenomectomyresultsinpatientswithcushingsdisease |