{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T06:24:35Z","timestamp":1648707875971},"reference-count":16,"publisher":"Akademiai Kiado Zrt.","issue":"18","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,5,1]]},"abstract":"<jats:p>A hipof\u00edzis adrenokortikotropin-termel\u0151 adenom\u00e1ja okozta Cushing-k\u00f3r \u00e9s az ectopi\u00e1s Cushing-szindr\u00f3ma elk\u00fcl\u00f6n\u00edt\u00e9se a hagyom\u00e1nyos hormonvizsg\u00e1latok \u00e9s a k\u00e9palkot\u00f3 vizsg\u00e1latok seg\u00edts\u00e9g\u00e9vel nem mindig lehets\u00e9ges. A k\u00e9t betegs\u00e9g elk\u00fcl\u00f6n\u00edt\u00e9s\u00e9nek aranystandardja napjainkban a sinus petrosus inferiorok szelekt\u00edv kat\u00e9terez\u00e9se (IPSS) sor\u00e1n nyert v\u00e9rmint\u00e1kb\u00f3l t\u00f6rt\u00e9n\u0151 ACTH-meghat\u00e1roz\u00e1s. A szerz\u0151k 1999 \u00e9s 2005 k\u00f6z\u00f6tt 34 Cushing-szindr\u00f3m\u00e1s betegen \u00f6sszesen 41 alkalommal v\u00e9geztek IPSS-t, akikn\u00e9l a dinamikus hormonvizsg\u00e1latok \u00e9s a k\u00e9palkot\u00f3 vizsg\u00e1latok alapj\u00e1n az ACTH-dependens Cushing-szindr\u00f3ma ok\u00e1t nem lehetett egy\u00e9rtelm\u0171en meg\u00e1llap\u00edtani. A beavatkoz\u00e1s szenzitivit\u00e1s\u00e1nak meghat\u00e1roz\u00e1sakor 25 beteg 31 vizsg\u00e1lat\u00e1nak eredm\u00e9ny\u00e9t \u00e9rt\u00e9kelt\u00e9k, akikn\u00e9l a v\u00e9gleges diagn\u00f3zist sikeres m\u0171t\u00e9ti beavatkoz\u00e1s vagy sz\u00f6vettani vizsg\u00e1lat er\u0151s\u00edtette meg (22 ACTH-termel\u0151 hipof\u00edzisadenoma, 3 ectopi\u00e1s Cushing-szindr\u00f3ma). Az IPSS eredm\u00e9ny\u00e9t pozit\u00edvnak tekintett\u00e9k, ha a kiindul\u00e1si centr\u00e1lis\/perif\u00e9ri\u00e1s plazma-ACTH-h\u00e1nyados &gt;2,0, vagy kortikotrop releasing hormon (CRH) ad\u00e1sa ut\u00e1n &gt;3,0 volt. A 31 vizsg\u00e1lat eredm\u00e9nye 20 esetben val\u00f3di pozit\u00edv, 3 esetben val\u00f3di negat\u00edv, 8 esetben \u00e1lnegat\u00edv volt, \u00e1lpozit\u00edv eset nem fordult el\u0151. Az eredm\u00e9nyek alapj\u00e1n az IPSS szenzitivit\u00e1sa 71,4%. Az \u00e1l-negat\u00edv 8 beteg k\u00f6z\u00fcl 4 esetben a vizsg\u00e1latot megism\u00e9telt\u00e9k, mind a n\u00e9gy betegben pozit\u00edv eredm\u00e9nnyel. Cushing-k\u00f3rban a 20 val\u00f3di pozit\u00edv vizsg\u00e1lat k\u00f6z\u00fcl 14 esetben a diagn\u00f3zis a 0 perces ACTH-szintek alapj\u00e1n is meg\u00e1llap\u00edthat\u00f3 volt, a CRH ut\u00e1ni 5 perces v\u00e9rmint\u00e1k alapj\u00e1n 19 betegn\u00e9l lehetett a Cushing-k\u00f3r diagn\u00f3zis\u00e1t meg\u00e1llap\u00edtani. Az IPSS vizsg\u00e1lat itt bemutatott els\u0151 hazai feldolgoz\u00e1s\u00e1ban a m\u00f3dszer szenzitivit\u00e1sa alacsonyabb, mint a j\u00f3val nagyobb betegforgalm\u00fa k\u00fclf\u00f6ldi endokrin centrumokban. A kisebb szenzitivit\u00e1s technikai okokon t\u00falmen\u0151en azzal is magyar\u00e1zhat\u00f3, hogy a szerz\u0151k az IPSS-t csak szigor\u00faan v\u00e1logatott esetekben, az egy\u00e9b vizsg\u00e1latokkal nem egy\u00e9rtelm\u0171en k\u00f3rism\u00e9zhet\u0151 betegeken v\u00e9gzik.<\/jats:p>","DOI":"10.1556\/oh.2007.28048","type":"journal-article","created":{"date-parts":[[2007,4,30]],"date-time":"2007-04-30T19:29:19Z","timestamp":1177961359000},"page":"843-847","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of the accuracy of inferior petrosal sinus sampling in the differential diagnosis of ACTH-dependent Cushing\u2019s syndrome"],"prefix":"10.1556","volume":"148","author":[{"given":"Mikl\u00f3s","family":"T\u00f3th","sequence":"first","affiliation":[{"name":"1 Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar II. 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