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DOI: 10.1055/s-0035-1549070
Examination and management tactics of patients with adrenal incidentaloma
Research purpose:
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To determine biochemical and clinical criteria of hormonal activity and signs of malignancy of adrenal incidentalomas
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To define sensitivity and specificity of the combination of standard methods to determine adrenal hormones with the study of steroid profiles by the methods of HPLC and GC-MS to reveal hormonal activity of adrenal formation
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To refine the algorithm of clinical laboratory diagnostics and management of patients with adrenal incidentalomas.
Methods:
Retro and prospective group research.
Research design:
The research will be conducted on 150 male/female patients aged 18 or above with newly diagnosed adrenal incidentaloma formation, as well as patients annually examined on the adrenal incidentaloma formations.
Research Groups Formation:
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Group: 30 patients with diagnosed incidentaloma, diagnosed 3 years ago
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Group: 30 patients with hormonally inactive formations of adrenal incidentaloma diagnosed 2 years ago
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Group: 30 patients with hormonally inactive formations of adrenal incidentaloma diagnosed a year ago
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Group: 60 patients with newly diagnosed adrenal incidentalomas (30 patients with a size < 4 cm formations and 30 patients with a size > 4 cm formations).
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Group: A control group comprised of 20 healthy males and females
Diagnostic methods:
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Clinical-anamnestic datas
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CLIA – AKTH, FF in saliva, UFF, DEAS, Renin
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ELISA -17-OHP, NMN, MN in blood and in urine
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RIA- PAC, PRA
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HPLC – level of F, E, B, 11-dehydrocoricosteron, 18-OHB, DOC and S in blood and FS, FB, 18-OHB, 6-β-OHF in urine
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GC-MS – THF, allo-THF, THE, THB, THS, 17OHdA2, DHA, dA3, dP2, dP3, 16-OHdP2
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Supresive test with 1, 2 mg of dexamethasone
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Test with physiological (salt) solution
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Visual diagnostic methods CT, MRI, Sonograph