Interpetrosal sphingosine-1-phosphate ratio predicting Cushing’s disease tumor laterality and remission after surgery
BackgroundCushing’s disease (CD) poses significant challenges in its treatment due to the lack of reliable biomarkers for predicting tumor localization or postoperative clinical outcomes. Sphingosine-1-phosphate (S1P) has been shown to increase cortisol biosynthesis and is regulated by adrenocortico...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-10-01
|
| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1238573/full |
| _version_ | 1827778198841065472 |
|---|---|
| author | Heng Sun Chunli Wu Biao Hu Yuan Xiao Yuan Xiao |
| author_facet | Heng Sun Chunli Wu Biao Hu Yuan Xiao Yuan Xiao |
| author_sort | Heng Sun |
| collection | DOAJ |
| description | BackgroundCushing’s disease (CD) poses significant challenges in its treatment due to the lack of reliable biomarkers for predicting tumor localization or postoperative clinical outcomes. Sphingosine-1-phosphate (S1P) has been shown to increase cortisol biosynthesis and is regulated by adrenocorticotropic hormone (ACTH).MethodsWe employed bilateral inferior petrosal sinus sampling (BIPSS), which is considered the gold standard for diagnosing pituitary sources of CD, to obtain blood samples and explore the clinical predictive value of the S1P concentration ratio in determining tumor laterality and postoperative remission. We evaluated 50 samples from 25 patients who underwent BIPSS to measure S1P levels in the inferior petrosal sinuses bilaterally.ResultsSerum S1P levels in patients with CD were significantly higher on the adenoma side of the inferior petrosal sinus than on the nonadenoma side (397.7 ± 15.4 vs. 261.9 ± 14.88; P < 0.05). The accuracy of diagnosing tumor laterality with the interpetrosal S1P and ACTH ratios and the combination of the two was 64%, 56% and 73%, respectively. The receiver operating characteristic curve analysis revealed that the combination of interpetrosal S1P and ACTH ratios, as a predictor of tumor laterality, exhibited a sensitivity of 81.82% and a specificity of 75%, with an area under the curve value of 84.09%. Moreover, we observed that a high interpetrosal S1P ratio was associated with nonremission after surgery. Correlation analyses demonstrated that the interpetrosal S1P ratio was associated with preoperative follicle-stimulating hormone (FSH), luteinizing hormone (LH), and postoperative ACTH 8 am levels (P < 0.05).ConclusionOur study demonstrated a significant association between the interpetrosal S1P ratio and tumor laterality, as well as postoperative remission in CD, suggesting that the interpetrosal S1P ratio could serve as a valuable biomarker in clinical practice. |
| first_indexed | 2024-03-11T14:29:46Z |
| format | Article |
| id | doaj.art-ff8a70b322d34b7c87d7a4eab7b4f782 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-11T14:29:46Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-ff8a70b322d34b7c87d7a4eab7b4f7822023-10-31T11:33:08ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-10-011410.3389/fendo.2023.12385731238573Interpetrosal sphingosine-1-phosphate ratio predicting Cushing’s disease tumor laterality and remission after surgeryHeng Sun0Chunli Wu1Biao Hu2Yuan Xiao3Yuan Xiao4Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, ChinaDepartment of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, ChinaDepartment of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, ChinaDepartment of Endocrinology, Endocrinology Research Center, Xiangya Hospital of Central South University, Changsha, Hunan, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, Hunan, ChinaBackgroundCushing’s disease (CD) poses significant challenges in its treatment due to the lack of reliable biomarkers for predicting tumor localization or postoperative clinical outcomes. Sphingosine-1-phosphate (S1P) has been shown to increase cortisol biosynthesis and is regulated by adrenocorticotropic hormone (ACTH).MethodsWe employed bilateral inferior petrosal sinus sampling (BIPSS), which is considered the gold standard for diagnosing pituitary sources of CD, to obtain blood samples and explore the clinical predictive value of the S1P concentration ratio in determining tumor laterality and postoperative remission. We evaluated 50 samples from 25 patients who underwent BIPSS to measure S1P levels in the inferior petrosal sinuses bilaterally.ResultsSerum S1P levels in patients with CD were significantly higher on the adenoma side of the inferior petrosal sinus than on the nonadenoma side (397.7 ± 15.4 vs. 261.9 ± 14.88; P < 0.05). The accuracy of diagnosing tumor laterality with the interpetrosal S1P and ACTH ratios and the combination of the two was 64%, 56% and 73%, respectively. The receiver operating characteristic curve analysis revealed that the combination of interpetrosal S1P and ACTH ratios, as a predictor of tumor laterality, exhibited a sensitivity of 81.82% and a specificity of 75%, with an area under the curve value of 84.09%. Moreover, we observed that a high interpetrosal S1P ratio was associated with nonremission after surgery. Correlation analyses demonstrated that the interpetrosal S1P ratio was associated with preoperative follicle-stimulating hormone (FSH), luteinizing hormone (LH), and postoperative ACTH 8 am levels (P < 0.05).ConclusionOur study demonstrated a significant association between the interpetrosal S1P ratio and tumor laterality, as well as postoperative remission in CD, suggesting that the interpetrosal S1P ratio could serve as a valuable biomarker in clinical practice.https://www.frontiersin.org/articles/10.3389/fendo.2023.1238573/fullipsssphingosine-1-phosphateCushing’s diseaseremissiontumor laterality |
| spellingShingle | Heng Sun Chunli Wu Biao Hu Yuan Xiao Yuan Xiao Interpetrosal sphingosine-1-phosphate ratio predicting Cushing’s disease tumor laterality and remission after surgery Frontiers in Endocrinology ipss sphingosine-1-phosphate Cushing’s disease remission tumor laterality |
| title | Interpetrosal sphingosine-1-phosphate ratio predicting Cushing’s disease tumor laterality and remission after surgery |
| title_full | Interpetrosal sphingosine-1-phosphate ratio predicting Cushing’s disease tumor laterality and remission after surgery |
| title_fullStr | Interpetrosal sphingosine-1-phosphate ratio predicting Cushing’s disease tumor laterality and remission after surgery |
| title_full_unstemmed | Interpetrosal sphingosine-1-phosphate ratio predicting Cushing’s disease tumor laterality and remission after surgery |
| title_short | Interpetrosal sphingosine-1-phosphate ratio predicting Cushing’s disease tumor laterality and remission after surgery |
| title_sort | interpetrosal sphingosine 1 phosphate ratio predicting cushing s disease tumor laterality and remission after surgery |
| topic | ipss sphingosine-1-phosphate Cushing’s disease remission tumor laterality |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1238573/full |
| work_keys_str_mv | AT hengsun interpetrosalsphingosine1phosphateratiopredictingcushingsdiseasetumorlateralityandremissionaftersurgery AT chunliwu interpetrosalsphingosine1phosphateratiopredictingcushingsdiseasetumorlateralityandremissionaftersurgery AT biaohu interpetrosalsphingosine1phosphateratiopredictingcushingsdiseasetumorlateralityandremissionaftersurgery AT yuanxiao interpetrosalsphingosine1phosphateratiopredictingcushingsdiseasetumorlateralityandremissionaftersurgery AT yuanxiao interpetrosalsphingosine1phosphateratiopredictingcushingsdiseasetumorlateralityandremissionaftersurgery |