Open AccessStudy of urine steroid profiles by gas chromatography-mass spectrometry in patients with adrenocortical cancer in the course of treatment
Author(s) -
Л И Великанова,
N V Vorokhobina,
Z R Shafigullina,
В. Ю. Бохян,
И. С. Стилиди,
Valentina V. Kalugina,
Ekaterina V. Malevanaya,
Е. Г. Стрельникова,
N. E. Kushlinskii
Publication year - 2021
Publication title -
alʹmanah kliničeskoj mediciny
Language(s) - English
Resource type - Journals
eISSN - 2587-9294
pISSN - 2072-0505
DOI - 10.18786/2072-0505-2021-49-041
Subject(s) - etiocholanolone , urine , medicine , excretion , adrenocortical carcinoma , dehydroepiandrosterone , pregnanediol , urinary system , urology , gas chromatography–mass spectrometry , endocrinology , gastroenterology , chemistry , hormone , mass spectrometry , androgen , chromatography
Background : Adrenocortical carcinoma (ACC) is a rare and aggressive disease. There are only few studies evaluating the diagnostic value of gas chromatography-mass spectrometry (GC-MS) for detection of ACC recurrence after surgery. It is necessary to conduct an in-depth study to search for the most informative markers of the disease relapse. Aim : To study urine steroid metabolism by GC-MS during treatment to identify early signs of metastatic disease and relapse. Materials and methods : Thirty nine (39) ACC patients were examined before and after surgery, in the early postoperative period ( 500 mcg/day that was typical for ACC patients. After surgery, decreased urinary excretion of THS (р 0.05) is a sign of metastatic diseases in the ACC patients at less than 1 year after the surgery, of the disease relapse at 2 to 5 years, and of the disease relapse after chemotherapy. In addition, in the ACC patients with metastatic disease within 1 year after surgery, increased progestogen urine excretion was found. Urine excretion of DHEA and its metabolites in the patients with the disease relapse after chemotherapy was not different from those in the ACC patients before surgery (p > 0.05). Conclusion : Determination of urine excretion of THS, DHEA and its metabolites, etiocholanolone, 5-ene-pregnenes, 3β,16,20-dP3, and 3α,16,20-dP3/3β,16,20-dP3 ratio by GC-MS is of utmost importance in the monitoring of treatment for ACC and early diagnosis of the disease progression.