Exp Clin Endocrinol Diabetes 2015; 123 - LB_04
DOI: 10.1055/s-0035-1549070

Examination and management tactics of patients with adrenal incidentaloma

NV Vorokhobina 1, LJ Velikanova 2, K Grigoryan 1
  • 1Lehrstuhl für Endokrinologie von V.G. Baranov der Nord-Westlichen Staatlichen Medizinischen Metschnikow Universität (NWSMU Metschnikow)
  • 2Forschungslaboratorium für Chromatografie des Forschungsinstitutes für Endokrinologie

Research purpose:

  • To determine biochemical and clinical criteria of hormonal activity and signs of malignancy of adrenal incidentalomas

  • 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

  • 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:

  • Group: 30 patients with diagnosed incidentaloma, diagnosed 3 years ago

  • Group: 30 patients with hormonally inactive formations of adrenal incidentaloma diagnosed 2 years ago

  • Group: 30 patients with hormonally inactive formations of adrenal incidentaloma diagnosed a year ago

  • 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).

  • Group: A control group comprised of 20 healthy males and females

Diagnostic methods:

  • Clinical-anamnestic datas

  • CLIA – AKTH, FF in saliva, UFF, DEAS, Renin

  • ELISA -17-OHP, NMN, MN in blood and in urine

  • RIA- PAC, PRA

  • 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

  • GC-MS – THF, allo-THF, THE, THB, THS, 17OHdA2, DHA, dA3, dP2, dP3, 16-OHdP2

  • Supresive test with 1, 2 mg of dexamethasone

  • Test with physiological (salt) solution

  • Visual diagnostic methods CT, MRI, Sonograph