Dissociation between plasma adrenocorticotropin and serum cortisol level during the early postoperative period after gastrectomy

Citation
Ym. Cho et al., Dissociation between plasma adrenocorticotropin and serum cortisol level during the early postoperative period after gastrectomy, HORMONE RES, 53(5), 2000, pp. 246-250
Citations number
19
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Endocrinology, Nutrition & Metabolism
Journal title
HORMONE RESEARCH
ISSN journal
0301-0163 → ACNP
Volume
53
Issue
5
Year of publication
2000
Pages
246 - 250
Database
ISI
SICI code
0301-0163(2000)53:5<246:DBPAAS>2.0.ZU;2-D
Abstract
We demonstrated the dissociation between plasma adrenocorticotropin (ACTH) and serum cortisol levels during the early recovery period after radical ga strectomy in 9 of 31 patients with gastric adenocarcinoma. Patients with th e dissociation between plasma ACTH and serum cortisol levels (DAC) showed a sustained elevation of serum cortisol level on the first or second postope rative day, while the plasma ACTH level returned to its preoperative state. These patients also had more advanced cancers (p < 0.05) and suffered from more postoperative complications (p < 0.05) than those without DAC. In the se patients with DAC, serum cortisol and interleukin (IL)-6 levels remained higher on the second postoperative day than in those of the patients witho ut DAC (21.80 +/- 1.57 vs, 13.68 +/- 0.72 mug/dl, p < 0.001, and 74.31 +/- 15.65 vs, 18.75 +/- 3.14 pg/ml, p < 0.001, respectively), On the second pos toperative day, serum IL-6 levels showed a significant correlation with ser um cortisol levels in all patients (r = 0.511, p < 0.01). These results sug gest th at the DAC du ri ng the early postoperative period after radical ga strectomy is associated with advanced stage of cancer and postoperative com plication, and that the increased serum IL-6 level is at least in part resp onsible for maintaining the elevated serum cortisol, Copyright (C) 2000 S. Karger AG,Basel.