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Multiple hormone secretion may indicate worse prognosis in patients with ectopic Cushing's syndrome.
Hormones ( IF 2.4 ) Pub Date : 2020-01-16 , DOI: 10.1007/s42000-019-00163-z Ieva Lase 1 , Ieva Strele 2 , Malin Grönberg 1 , Gordana Kozlovacki 1 , Staffan Welin 1 , Eva Tiensuu Janson 1
中文翻译:
多激素分泌可能表明异位库欣综合症患者的预后较差。
更新日期:2020-01-16
Hormones ( IF 2.4 ) Pub Date : 2020-01-16 , DOI: 10.1007/s42000-019-00163-z Ieva Lase 1 , Ieva Strele 2 , Malin Grönberg 1 , Gordana Kozlovacki 1 , Staffan Welin 1 , Eva Tiensuu Janson 1
Affiliation
Purpose
Ectopic Cushing’s syndrome (ECS) caused by an ACTH secreting neuroendocrine neoplasm (NEN) is a rare and challenging condition. We aimed to detect predictive and prognostic parameters for ECS patients identified from a retrospective, comprehensive cohort of NENs treated at a tertiary referral center.Methods
Medical records of 886 patients with NENs were reviewed. We identified 51 patients with ECS (33 females/18 men); mean age 52 ± 15 years (SD). Clinical parameters including symptoms, biochemical markers, and survival were extracted and further analyzed.Results
The primary tumor was located in the thorax (n = 28) or pancreas (n = 15) or was of unknown primary origin (n = 8). In 30 patients, tumor and ECS were diagnosed simultaneously. In 12 patients, the NEN diagnosis preceded ECS development, with a median time of 43.5 months (range: 9–96), and 10 of these showed radiological tumor progression at ECS diagnosis. Twenty-one patients had multiple hormone secretion, which correlated with shorter overall survival (OS), p = 0.012 (HR 2.4 (95% CI 1.2–4.9)), as did high morning cortisol, p = 0.037 (HR 2.3 (1.0–5.2)), higher tumor grade, p = 0.044 (HR 2.3 (1.0–5.1)), and diabetes, p = 0.050 (HR 2.4 (1.0–6.0)).Conclusions
Multiple hormone secretion, high morning cortisol, higher tumor grade, and diabetes were correlated with shorter OS. Development of ECS in patients with a non-functioning NEN may indicate tumor progression. Multiple hormone secretion should be considered as a bad prognostic sign in ECS patients and should lead to intensified clinical management.中文翻译:
多激素分泌可能表明异位库欣综合症患者的预后较差。