[Value of alpha subunit assay in pituitary pathology]

Ann Endocrinol (Paris). 1992;53(4):138-46.
[Article in French]

Abstract

We evaluated serum alpha-subunit concentrations in 72 patients bearing pituitary adenomas. We conclude that: 1) alpha-subunit hypersecretion is found in all patients with TSH secreting pituitary adenoma (n = 10). Two patients have a predominant secretion of alpha-subunit as compared to TSH secretion. 2) As concerns gonadotropin secreting pituitary adenomas (n = 3), all patient have elevated serum alpha-subunit levels with increased FSH and LT concentrations in 2 cases and 1 case respectively. 3) In prolactinomas (n = 14), alpha-subunit concentrations are not significantly different from that of normal subjects. 4) In 11 acromegalic patients, alpha-subunit hypersecretion is found in 2 patients only with GH-alpha and GH-PRL-alpha secreting pituitary adenomas. 5) Among 34 patients with nonsecreting adenomas, 8 have elevated alpha-subunit concentrations (24%). Positive immunocytochemical staining is found in 70% most often with gonadotropins (55%). Only a few pituitary tumors with positive alpha-subunit immunocytochemical staining have elevated serum alpha-subunit levels. At least, the measurement of basal circulating alpha-subunit levels is very useful in the follow-up of patients with nonsecreting adenomas. In our study, medical treatments including bromocriptine and somatostatin analogues have been found effective in patients with alpha-subunit hypersecretion. Further investigations are necessary to prove if such treatments could control tumoral growth and could prevent recurrences.

MeSH terms

  • Acromegaly / blood
  • Adenoma / blood*
  • Adenoma / drug therapy
  • Adenoma / metabolism
  • Adult
  • Aged
  • Bromocriptine / therapeutic use
  • Female
  • Glycoprotein Hormones, alpha Subunit / blood*
  • Gonadotropins, Pituitary / metabolism
  • Humans
  • Male
  • Middle Aged
  • Octreotide / therapeutic use
  • Pituitary Neoplasms / blood*
  • Pituitary Neoplasms / drug therapy
  • Pituitary Neoplasms / metabolism
  • Prolactinoma / blood
  • Prolactinoma / metabolism

Substances

  • Glycoprotein Hormones, alpha Subunit
  • Gonadotropins, Pituitary
  • Bromocriptine
  • Octreotide