The New Diagnostic Criteria And Molecular Markers Histiocytosis Application And Evaluation In Primary Aldosteronism

Part OneComparison of the different methodsforscreening primary aldosteronism in hypertensive patients.Abstract:Objective:We tried to use new indexes of ARR> serum sodium to serum potassium (SP)、serum sodium to (serum potassium)2(SPP)、serum sodium to urinary sodium to serum potassium to urinary potassium(SUSPUP)and serum sodium to urinary sodium to (serum potassium)2to urinary potassium(SUSPPUP)in screening of PA.Methods:The present study ineluded65patients with essential hypertension and39patients with PA. serum aldosterone concentration、plasma rennin activity、serum potassium and sodium、urine potassium and sodium were measured. Comparison of the different methods for screening primary aldosteronism in hypertensive patients.Result:Compared with essential hypertension, PA patients had lower levels of both serum potassium and urine sodium. higher levels of serum sodium and urine potassium. The PA patients had the higher SP、SPP、SUSPUP and SUPPUP ratio (P<0.01). The AUCs of ARR、SP、SPP、SUSPUP and SUSPPUP were0.999、0.832、0.829、0.655、0.730respectively according to the ROC curve. The optimal cutoffs of ARR is30.08, the sensitivity is100%and specificity is98.6%. The optimal cutoffs of SP is40.53, the sensitivity is73.2%and specificity is87.0%. The optimal cutoffs of SPP is12.14, the sensitivity is69.6%and specificity is87%. The optimal cutoffs of SUSPUP is10.83, the sensitivity is60.7%and specificity is69.6%. The optimal cutoffs of SUSPPUP is2.64, the sensitivity is71.4%and specificity is68.1%.Condusion:The SP、SPP had higher sensitivity and specificity than SUSPUP and SUSPPUP ratios They are rapid and inexpensive indices to assess the extent of mineralocortieoid excess. Therefore they may be employed to screen PA in hypertensive patients. Part TwoThe expression of Dab2innormal adrenal and different Adrenocortical adenomasAbstract:Objective:We tried to study the expression of Dab2in normal adrenal; and further more, discusses the expression of Dab2in different adrenocortical adenomas.Methods:Compare the expression of Dab2in5normal adrenal、5aldosterone-producing adenoma、5cortisol-producing adenoma and5no-functional adenoma using immunohistochemical method. RNA was extracted from3normal adrenal、6aldosterone-producing adenoma、5cortisol-producing adenoma and4no-functional adenoma, CYP11B1mRNA, CYP11B2mRNA, and Dab2mRNA expression were studied through Real-time PCR method.Result:In normal adrenal, Dab2was significant high expressed in zona glomerulosa, and was lower expressed in zona fasciculate and zona reticularis. In aldosterone-producing adenoma, Dab2can be seen in clumps high expression, in cortisol-producing adenoma and no-functional adenoma, it was low expression. Compared with normal adrenal, CYP11B2mRNA was higher expressed in aldosterone-producing adenoma, and compared with peritumoral tissue, it was higher expressed in aldosterone-producing adenoma and no-functional adenoma. Compared with normal adrenal, CYP11B1mRNA was higher expressed in aldosterone-producing adenoma and cortisol-producing adenoma, and compared with peritumoral tissue, it was higher expressed in cortisol-producing adenoma. Compared with normal adrenal, Dab2mRNA was higher expressed in aldosterone-producing adenoma, and compared with peritumoral tissue, it was also higher expressed in aldosterone-producing adenoma.Condusion:In normal adrenal, Dab2was significant high expressed in zona glomerulosa, and Dab2was higher expressed in aldosterone-producing adenoma. Further research is need to determine whether Dab2can be a specific marker for pathology diagnosis of primary aldosteronism.