Lahlou N, Le Nestour E, Chanson P, Seret-Bégué D, Bouchard P, Roger M, Warnet A
Fondation de Recherche en Hormonologie, Paris/Fresnes, France.
Clin Endocrinol (Oxf). 1993 Mar;38(3):301-9. doi: 10.1111/j.1365-2265.1993.tb01010.x.
Gonadotroph adenomas are generally revealed by symptoms of mass effect at the stage of macroadenoma. Most of them hypersecrete FSH and/or gonadotrophin subunits. Rarely they hypersecrete LH, which could induce endocrinological symptoms. As the glycoprotein inhibin is secreted by the gonads under FSH control, we have evaluated whether high immunoreactive inhibin (iINH) levels correlated with FSH hypersecretion and whether iINH and FSH levels were related to tumour volume in subjects with gonadotroph adenomas.
Forty-five patients (30 men, 15 women) were retrospectively selected on the basis of immunostaining technique using specific antibodies raised against FSH-beta, LH-beta and glycoprotein alpha-subunit.
Immunoreactive inhibin (iINH) was measured by radioimmunoassay using antiserum 1989 raised to bovine inhibin. Tumour volume index was the product in cm3 of length, width and height of the adenoma as assessed by computerized tomography.
In men (age 21-61 years), iINH levels were positively correlated with FSH levels (Spearman's r = 0.67, P < 0.001), and both iINH and FSH levels were significantly correlated with tumour volume index (Spearman's r = 0.38, P < 0.05 and r = 0.39, P < 0.05 respectively). In the subgroup of men with normal FSH levels (n = 17), the correlation of FSH with tumour volume index was high: Spearman's r = 0.56, P < 0.05. In the post-menopausal women (n = 8, age > 55 years), iINH levels were undetectable or below the follicular phase range regardless of FSH values. In the premenopausal women (n = 7, age 22-49 years, follicular phase or amenorrhoea) iINH levels were above follicular phase range in three women including one who had very high FSH levels.
These data show that in men with gonadotroph adenoma FSH levels are related to tumour mass and suggest that a significant part of circulating FSH in patients with normal FSH levels arises from the tumour. The significant correlation between iINH and FSH levels demonstrates that tumoral FSH is bioactive and that high iINH levels do not exert any feedback control on tumoral FSH secretion. Therefore the coexistence of high FSH levels with high iINH levels is strongly suggestive of a gonadotroph adenoma. Gonadotroph adenomas seem to represent a unique model of long-term FSH stimulation of inhibin-producing cells, in some way analogous to that created by repetitive administration of exogenous FSH.
促性腺激素腺瘤通常在大腺瘤阶段因占位效应的症状而被发现。其中大多数会过度分泌促卵泡激素（FSH）和/或促性腺激素亚基。很少有过度分泌促黄体生成素（LH）的情况，这可能会引发内分泌症状。由于糖蛋白抑制素是在FSH的控制下由性腺分泌的，我们评估了高免疫反应性抑制素（iINH）水平是否与FSH过度分泌相关，以及iINH和FSH水平是否与促性腺激素腺瘤患者的肿瘤体积有关。
基于使用针对FSH-β、LH-β和糖蛋白α亚基的特异性抗体的免疫染色技术，回顾性选取了45例患者（30名男性，15名女性）。
使用针对牛抑制素产生的抗血清1989通过放射免疫测定法测量免疫反应性抑制素（iINH）。肿瘤体积指数是通过计算机断层扫描评估的腺瘤长度、宽度和高度（以立方厘米为单位）的乘积。
在男性（年龄21 - 61岁）中，iINH水平与FSH水平呈正相关（斯皮尔曼相关系数r = 0.67，P < 0.001），并且iINH和FSH水平均与肿瘤体积指数显著相关（斯皮尔曼相关系数分别为r = 0.38，P < 0.05和r = 0.39，P < 0.05）。在FSH水平正常的男性亚组（n = 17）中，FSH与肿瘤体积指数的相关性较高：斯皮尔曼相关系数r = 0.56，P < 0.05。在绝经后女性（n = 8，年龄> 55岁）中，无论FSH值如何，iINH水平均无法检测到或低于卵泡期范围。在绝经前女性（n = 7，年龄22 - 49岁，卵泡期或闭经）中，三名女性的iINH水平高于卵泡期范围，其中一名女性的FSH水平非常高。
这些数据表明，在患有促性腺激素腺瘤的男性中，FSH水平与肿瘤大小有关，并表明FSH水平正常的患者中循环FSH的很大一部分来自肿瘤。iINH和FSH水平之间的显著相关性表明肿瘤性FSH具有生物活性，并且高iINH水平对肿瘤性FSH分泌没有任何反馈控制作用。因此，高FSH水平与高iINH水平并存强烈提示促性腺激素腺瘤。促性腺激素腺瘤似乎代表了长期FSH刺激抑制素产生细胞的独特模型，在某种程度上类似于通过重复给予外源性FSH所产生的模型。
