title: [The value and comparison of plasma adrenocorticotropic hormone and urinary free cortisol in predicting long-term outcome after operation of Cushing's disease].
abstract: Objective:To study and the value of morning plasma adrenocorticotropic hormone (ACTH) and urinary free cortisol (24 h UFC) within 3 days after operation in patients with Cushing's disease in predicting the long-term outcome.Methods:The clinical data of 140 patients with Cushing's disease who were treated in Department of Neurosurgery of PUMCH from 2012 to 2014 were analyzed retrospectively.The univariate analysis, multivariate Logistic analysis, ROC curve analysis and other statistical methods were used to study the predicting value of morning plasma ACTH and 24 h UFC in 3 days post operation.Results:Univariate analysis showed that in the two groups of the early remission and no remission, there was significant statistical difference between the preoperative ACTH, preoperative 24 h UFC, postoperative ACTH and postoperative 24 h UFC (P<0.05, <0.01, <0.01). Logistic analysis showed that ACTH and 24 h UFC after operation of two groups had significant difference (P<0.01, <0.05). ROC curve analysis showed that postoperative cutoff values of ACTH and 24 h UFC were 4.11 pmol/L (18.7 pg/ml) and 281.42 nmol (102 μg)/24 h. ROC analysis was performed to evaluate the predicting performance of postoperative ACTH, resulting in an area under the curve (AUC) of 0.917 (95%CI: 0.858-0.957,P<0.01). In comparison, 24 h UFC had an AUC of 0.814 (95%CI: 0.739-0.875,P<0.01). The predicting value of ACTH is significantly better than that of 24 h UFC (P=0.005).Conclusion:Early morning 24 h UFC and ACTH within 3 days after operation both showed considerable accuracy in predicting the long-term outcome of Cushing's disease, and the significance of ACTH was even greater than that of 24 h UFC.
authors.affiliation: *Department of Neurosurgery, Pekinbng Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
authors.forename: M
authors.initials: M
authors.lastname: Feng
authors.forename: X H
authors.initials: XH
authors.lastname: Liu
authors.forename: X J
authors.initials: XJ
authors.lastname: Bao
authors.forename: C X
authors.initials: CX
authors.lastname: Yong
authors.forename: L
authors.initials: L
authors.lastname: Lu
authors.forename: K
authors.initials: K
authors.lastname: Deng
authors.forename: W
authors.initials: W
authors.lastname: Lian
authors.forename: B
authors.initials: B
authors.lastname: Xing
authors.forename: H J
authors.initials: HJ
authors.lastname: Zhu
authors.forename: W B
authors.initials: WB
authors.lastname: Ma
authors.forename: Y
authors.initials: Y
authors.lastname: Yan
authors.forename: R Z
authors.initials: RZ
authors.lastname: Wang
mesh_terms: D000324:Adrenocorticotropic Hormone; D006801:Humans; D006854:Hydrocortisone; D009493:Neurosurgery; D047748:Pituitary ACTH Hypersecretion; D011184:Postoperative Period; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone