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Abstract
Despite the rapid development and improvement of diagnostic capabilities in oncology and endocrinology, the diagnosis of neoplastic hypercorticism syndrome remains one of the most complex and unresolved issue of modern medicine. The aim — to find out the possibility of dependence of the level of adrenocorticotropic hormone of the peripheral blood on the localization and spread of neuroendocrine tumors of the chest accompanied by ectopic
Cushing’s syndrome at an early, pre-visual stage of diagnosis. Material and methods. The literature data, which contained information about the change in the level of adrenocorticotropic hormone and the degree of spread of the tumor process of 71 patients with neuroendocrine tumors of the chest, were analyzed. According to the localization of tumors, patients were divided into 3 clinical groups. The first group (bronchopulmonary carcinoid) consisted of 30 patients, including 23 patients with a local tumor process; second group (small cell lung cancer) — 4 patients, all with spread process; the third group (carcinoid/thymus carcinoma) — 37 patients, including 17 patients with local process. The indicator of the level of adrenocorticotropic hormone in the peripheral blood of patients is presented as the ratio: the level of adrenocorticotropic hormone of the patient / value of the upper limit of normal. Results. The highest level of adrenocorticotropic hormone was identified in the group of small cell lung cancer — an increase of 11.2±9.89 times, on the contrary, in the group of thymomas — 7.4±7.7 times (p <0.05), while in the subgroup of the local stage thymomas the level is slightly higher than in the group of spread stage thymomas — an increase of 8.6±8.43 and 6.38±7.08 times, respectively (p<0.05). In the group of bronchopulmonary carcinoid with an average increase in the level of adrenocorticotropic hormone in 3.28±2.54 times in the general group as well as in the subgroup with local tumor process the average level of adrenocorticotropic hormone is higher than in the group with the spread process — an increase of 3.45±2,78 and 2.72±1.53 times, respectively (p<0.05). Conclusion. Based on the results of the data obtained, it became possible to modify the diagnostic algorithm on a case-by-case basis for patients with this
pathology, which made it possible to make an economically and radiologically reasonable choice of a further diagnostic step.
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