前立腺癌患者における血漿11-deoxycortisolを指標としたsingle dose metyrapone testの検討

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A radioimmunoassay procedure for plasma 11-deoxycortisol (S) was developed using an antiserum prepared by immunizing rabbits with S-21-hemissuccinate bovine serum albumin and S-3-oxime-bovine serum albumin. Thereafter plasma S, cortisol (F) and adrenocorticotropic hormone (ACTH) responses to metyrapone were investigated in 13 normal adult males and 39 patients with prostatic cancer. The results were as follows : 1) The antiserum against S-3-oxime-bovine serum albumin had less cross reactivity (<10%) with other steroids than that against S-21-hemissuccinate bovine serum albumin and obtained a good standard curve. The intraassay variance and interassay variance of this method using the former antiserum (N=10) were 12.4% asd 14.9% respectively, and the blank value was 3.7±1.6 pg. 2) Basal levels of S, F and ACTH in plasma from 13 normal adult males, ranged 21-80 years old, were 98.4±15.7 ng/dl (mean value±S.E.), 12.7 + 0.78μg/dl and 30.6±3.02 pg/ml respectively. Those levels increased to 7060±598 ng/dl, 24.3±1.69μg/dl and 24.3±1.6 pg/ml at 9 a.m. following oral administration of metyrapone (30 mg/kg b.w.) at midnight. 3) Both basal levels and responses of plasma S and F to metyrapone increased remarkably, while those of ACTH were within the normal range in prostatic cancer patients during the estrogen therapy. It was considered that protein-bound S and F increased following elevation of corticosteroid binding globulin but returned to the normal range about 2 weeks after discontinuation of the therapy. 4) In cases treated with estrogens, plasma S, F and ACTH responses to metyrapone were unchanged compared to normal adult males 2-4 weeks after discontinuation of the thereapy, and this data suggested that estrogens had no inhibitory effect on the pituitary-adrenal axis. However, in cases treated with progestational agents over a long-term period, plasma S and ACTH responses to metyrapone decreased slightly but returned to the normal range 2-4 weeks after discontinuation of the therapy. This suggested that the inhibitory effect of these agents on the pituitary-adrenal axis was mild and reversible.
日本内分泌学会の論文

前立腺癌患者における血漿11-deoxycortisolを指標としたsingle dose metyrapone testの検討

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