Merola B, Colao A, Rossi E, La Tessa G, Spaziante R, Lombardi G
Cattedra di Endocrinologia, II Facoltà di Medicina, Università di Napoli, Italy.
Acta Endocrinol (Copenh). 1992 May;126(5):419-24. doi: 10.1530/acta.0.1260419.
The aim of this retrospective study was to evaluate the existence of a multihormonal gradient between the inferior petrosal sinuses in various pituitary diseases: Cushing's disease (8 cases), acromegaly (4 cases), prolactinomas (7 cases), GH, PRL-secreting adenoma (1 case), functionless adenoma (2 cases), empty sella (3 cases) and in non-tumoral hyperprolactinemia (5 cases). A significant intersinus gradient (more than 1.4:1) was recorded for GH, ACTH and PRL in 16 patients (80%), but in only 9 patients (45%) out of the 20 with hormone-secreting tumors for TSH, FSH and LH. Moreover, of the 10 patients in the remaining groups, only in two cases was a significant intersinus gradient present: one for GH and one for LH. In conclusion, the finding of a multihormonal release in the inferior petrosal sinus ipsilateral to the adenoma is reported, for the first time, in patients with GH- and PRL-secreting adenomas. The possible explanation for such a finding may be either an increased blood flow in this site of sampling or a pituitary multihormone release through a paracrine mechanism primed by the tumoral hypersecreted hormone. In addition, the pulsatile secretory pattern and the short half-life of polypeptide hormones may contribute to better demonstrate this phenomenon in respect to glycoprotein hormones.
本回顾性研究的目的是评估在各种垂体疾病中，岩下窦之间多激素梯度的存在情况，这些疾病包括：库欣病（8例）、肢端肥大症（4例）、催乳素瘤（7例）、生长激素和催乳素分泌腺瘤（1例）、无功能腺瘤（2例）、空蝶鞍（3例）以及非肿瘤性高催乳素血症（5例）。16例患者（80%）的生长激素、促肾上腺皮质激素和催乳素记录到显著的窦间梯度（超过1.4:1），但在20例分泌激素肿瘤患者中，仅9例（45%）的促甲状腺激素、促卵泡激素和促黄体生成素存在显著的窦间梯度。此外，在其余组的10例患者中，仅2例存在显著的窦间梯度：1例为生长激素，1例为促黄体生成素。总之，首次在生长激素和催乳素分泌腺瘤患者中报道了在腺瘤同侧岩下窦存在多激素释放的情况。对此发现的可能解释可能是该采样部位的血流增加，或者是通过肿瘤过度分泌的激素引发的旁分泌机制导致垂体多激素释放。此外，多肽激素的脉冲分泌模式和短半衰期可能有助于相对于糖蛋白激素更好地证明这一现象。
