The use of β-subunits of gonadotrophin hormones in the follow-up of clinically non-functioning pituitary tumours

Yona Greenman, Karen Tordjman, Dalia Sömjen, Irith Reider-Groswasser, Fortune Kohen, George Ouaknine, Naftali Stern*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: Clinically nonfunctioning pituitary adenomas (NFA) are mostly of gonadotroph origin. However, increased levels of circulating hormones or subunits in patients with NFA usually do not cause clinical symptoms, nor are they used as biological tumour markers. In this study we assessed the value of measuring β subunits of gonadotrophin hormones in the post-operative follow-up of patients bearing these tumours. DESIGN: Patients harbouring NFA were studied before and three months after transphenoidal pituitary surgery. β-LH and β-FSH levels were measured before and following TRH administration on the two occasions. Hormone levels were analyzed in relation to imaging studies performed before and after surgery. PATIENTS: Twenty four patients operated at the Tel Aviv-Sourasky Medical Centre for NFA. RESULTS: Pathological β-FSH and β-LH levels were detected in 79% and 60% of patients respectively. βLH levels decreased after surgery but there were no significant changes in β-FSH levels. There was a tendency for tumours with high basal β-LH levels to be larger and to have a poor surgical outcome. Normalization of β-LH levels post-operatively was usually associated with a decrease in tumour mass or complete removal of the tumour. Persistent pathological responses of β-LH to TRH after surgery were common in patients with residual tumours on imaging. Nevertheless there were exceptions to this pattern, rendering post-operative β-LH levels insufficiently reliable as a marker for the presence of residual tumour. CONCLUSION: Although there appears to be a relationship between β-LH levels, tumour size and surgical outcome, this association is presently insufficient to allow the routine use of either basal or TRH induced β-LH responses in the post-surgical follow- up of clinically nonfunctioning pituitary adenomas.

Original languageEnglish
Pages (from-to)185-190
Number of pages6
JournalClinical Endocrinology
Volume49
Issue number2
DOIs
StatePublished - 1998

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