EP1189 - ECE_3026 - A comparative evaluation of immunoinflammatory blood biomarkers in Cushing's disease and nonfunctioning pituitary adenomas
Bildiriler > Özet Bildiri
Yazarlar: Hatice ÖZIŞIK, Adil Bahadir, Su Ozgur, Ezgi Ulas, Mehmet Yigit, Şevki ÇETİNKALP, Mehmet ERDOĞAN
European Journal of Endocrinology, , , Uluslararası, Özet Bildiri, Wos, cilt 195
DOI: 10.1093/ejendo/lvag096.1442
Özet
Abstract Introduction Cushing's disease (CD), caused by adrenocorticotropic hormone–secreting pituitary adenomas, is characterized by pituitary-dependent chronic hypercortisolism with marked effects on immune and hematological parameters. Excess cortisol leads to leukocytosis, neutrophilia, and lymphopenia, resulting in a distinct immunological profile that may be reflected in peripheral blood cell–derived inflammatory indices. Nonfunctioning pituitary adenomas (NFPAs), although hormonally inactive, may also exert systemic effects through mass-related pituitary dysfunction and tumor-associated inflammation. This study aimed to comparatively evaluate peripheral blood–derived immunoinflammatory markers in patients with Cushing's disease and nonfunctioning pituitary adenomas and to assess their discriminative and independent associations. Methods This retrospective study included 108 patients, comprising 19 patients with Cushing's disease and 89 patients with nonfunctioning pituitary adenomas. Standard laboratory parameters derived from complete blood counts were used to calculate immunoinflammatory indices, including commonly used ratios neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), eosinophil-to-lymphocyte ratio (ELR), platelet-to-neutrophil ratio (PNR), mean platelet volume to absolute lymphocyte count ratio (MPV/ALC), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), pan-immune-inflammation value (PIV), derived NLR, and the fibrosis-4 (FIB-4) index. Intergroup comparisons, receiver operating characteristic (ROC) analyses, and multivariable logistic regression adjusted for age and sex were performed. Results Patients with Cushing's disease were significantly younger than NFPA patients (median age: 43 vs 60 years, P < .001) and exhibited a more pronounced pro-inflammatory hematological profile. Compared with the NFPA group, patients with CD had significantly higher leukocyte and neutrophil counts and lower lymphocyte percentages, resulting in elevated NLR, SIRI, SII, PIV, and derived NLR (all P < .05). ROC analysis showed modest-to-moderate distinctive performance for these indices (AUC range: 0.66-0.69), while FIB-4 showed the highest distinctive accuracy (AUC = 0.78). FIB-4 was included as a surrogate marker of cortisol-related metabolic and hepatic involvement. In multivariable logistic regression analyses adjusted for age and sex, only SIRI remained independently associated with Cushing's disease (odds ratio 2.42, 95% confidence interval 1.19-4.90, P = .014). Conclusions Peripheral blood–derived immunoinflammatory markers demonstrate distinct differences between Cushing's disease and nonfunctioning pituitary adenomas and show moderate disc ability. Among these markers, SIRI emerges as the only robust immunoinflammatory index independently associated with Cushing's disease, suggesting its potential utility as an easily accessible adjunctive biomarker reflecting disease-related immune dysregulation. Prospective studies with larger cohorts are warranted to confirm these findings and clarify their clinical applicability.