White M C, Daniels M, Newland P, Thompson C J, Cook D, Dewar J, Perry R, Jewitt R, Mathias D, Murdoch A P
Department of Medicine, University of Newcastle on Tyne, UK.
Clin Endocrinol (Oxf). 1990 Jun;32(6):681-8. doi: 10.1111/j.1365-2265.1990.tb00914.x.
Serum concentrations of LH and FSH and their response to the separate administration of GnRH (100 micrograms i.v.) and TRH (200 micrograms i.v.) have been studied preoperatively in 12 patients with a clinically functionless pituitary adenoma, of whom nine (3F: 6M) were found to secrete gonadotrophins in vitro. In three patients with a gonadotrophin-secreting adenoma (GSA) the pulsatile release of LH and FSH was also assessed preoperatively. An elevated serum FSH was recorded in six of nine patients with a GSA, and was subnormal in one, whilst an elevated LH was recorded in only two and was subnormal in six. A doubling of LH occurred in only four of the nine patients after GnRH and in three of six after TRH. None of the three patients with a non-GSA was shown to have an aberrant response to GnRH or TRH. In patients with a GSA, pulsatile release of LH and FSH was usually asynchronous and neither hormone demonstrated any regular harmonic pattern. These data show that in patients with a GSA the serum FSH level is usually elevated but this is not invariable, and the LH may well be low. Pathological responses of LH are frequently found following the administration of either GnRH or TRH and these stimulation tests should be performed separately in patients presenting with a clinically 'non-functioning' pituitary tumour to assist in the preoperative diagnosis. The absence of normal LH and FSH pulsing also appears to be a feature of GS adenomas, and suggests that tumorous gonadotrophin secretion is not under physiological control by hypothalamic GnRH.
术前对12例临床无功能垂体腺瘤患者的血清促黄体生成素（LH）和促卵泡生成素（FSH）浓度及其对单独静脉注射促性腺激素释放激素（GnRH，100微克）和促甲状腺激素释放激素（TRH，200微克）的反应进行了研究，其中9例（3例女性：6例男性）在体外被发现分泌促性腺激素。对3例分泌促性腺激素腺瘤（GSA）患者术前也评估了LH和FSH的脉冲式释放。9例GSA患者中有6例血清FSH升高，1例低于正常水平，而LH升高的仅2例，6例低于正常水平。9例患者中仅4例在注射GnRH后LH加倍，6例中的3例在注射TRH后LH加倍。3例非GSA患者对GnRH或TRH均未表现出异常反应。在GSA患者中，LH和FSH的脉冲式释放通常不同步，两种激素均未表现出任何规律的谐波模式。这些数据表明，GSA患者血清FSH水平通常升高，但并非一成不变，LH很可能较低。在注射GnRH或TRH后经常发现LH的病理性反应，对于临床表现为“无功能”垂体肿瘤的患者，应分别进行这些刺激试验以协助术前诊断。LH和FSH正常脉冲式释放的缺失似乎也是GSA腺瘤的一个特征，这表明肿瘤性促性腺激素的分泌不受下丘脑GnRH的生理控制。
