Artikel
Positive prediction value of the common consensus criteria for acromegaly remission
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Autoren
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A. Grote
- Neurochirurgische Klinik, Rheinische Friedrich-Wilhelms-Universität, Bonn
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A. Höllig
- Neurochirurgische Klinik, Rheinische Friedrich-Wilhelms-Universität, Bonn
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R. Kristof
- Neurochirurgische Klinik, Rheinische Friedrich-Wilhelms-Universität, Bonn
| Veröffentlicht: | 20. Mai 2009 |
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Gliederung
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Objective: This study tests for the first time the positive prediction value of the common consensus criteria of endocrinological remission of acromegaly following transsphenoidal surgery of GH secreting pituitary adenomas.
Methods: The data of 98 successive patients (56 ♀, 42 ♂) were analysed retrospectively from the medical records. All of them underwent first time transsphenoidal surgery of GH secreting pituitary adenoma. Data of 4 patients had to be excluded because of insufficient data. According to the common consensus endocrinological criteria of acromegaly remission, acromegaly was considered to be in remission, if 3 months postoperatively GH was suppressed to <1µg/dl by OGTT and IGF-1 was within normal limits. Positive predictive values (ppv) were calculated for the continuance of acromegaly.
Results: 67 (71,2%) patients were postoperatively in remission, while 27 (28,8%) patients had persisting acromegaly. During the mean follow-up of 6.3 years, acromegaly recurrence rate was 2.9%. The data of these two patients were considered to the time point of acromegaly recurrence.
The OGTT suppressed nadir GH-value and the IGF-1 value had early postoperative ppv of 53% and 67% respectively. The combination of these two tests, i.e. the common consensus criteria for acromegaly remission, had a ppv of 59%. The OGTT suppressed nadir GH-value and the IGF-1 value had a 3 months postoperative ppv of 100% and 100% respectively. The combination of these two tests, i.e. the common consensus criteria for acromegaly remission, had 3 month postoperative a ppv of 100%. The OGTT suppressed nadir GH-value and the IGF-1 value at the latest follow-up examination had a ppv of 100% and 100% respectively. The combination of these two tests, i.e. the common consensus criteria for acromegaly remission, also had a ppv of 100%.
Conclusions: These data show a increase of the positive prediction value of the common consensus criteria of acromeglay remission within the first few postoperative weeks. Thereafter the common consensus criteria of acromegaly remission were confirmed for the first time to have a very high ppv in diagnosing acromegaly remission, from 3 months postoperatively to long time follow-up.
