ACTA ENDOCRINOLOGICA (BUC)

Introduction. The blood brain barrier (BBB) restricts the transport of hydrophilic molecules such as peptidic pituitary hormones into the brain tissue. The blood-cerebrospinal fluid (CSF) is a part of the BBB.\r\nAim To compare the pituitary hormone levels on the two sides of the BBB in a group of subjects without endocrine diseases.\r\nPatients and methods. We investigated, with the approval of the local ethics committee, 78 subjects without endocrine diseases. Growth hormone (GH), prolactin (PRL), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and thyroid stimulating hormone (TSH) were measured by rapid fluoroimmunoassay with Europium in the blood and cerebrospinal fluid (CSF)sampled simultaneously before rachianestesia for minor surgery.\r\nResults. CSF concentrations are significantly lower than the corresponding serum ones for all hormones studied: 0.04 ? 0.009 mU/mL vs 2.29 ? 0.57 mU/mL for GH, 1.49 ? 0.078 ng/mL vs 10.07 ? 1.42 ng/mL for PRL, 0.57 ? 0.078 U/L vs 22.71 ? 3.65 U/L for FSH, 0.39 ? 0.038 U/L vs 11.11 ? 1.55 U/L for LH and 0.01 ? 0.003 &#956;U/mL vs 1.36 ? 0.17&#956;U/mL for TSH (mean ? SEM; p<0.001). The CSF/serum ratio was below 1 in the vast majority of cases (from all subjects studied we only found 3 cases with supraunitary CSF/serum ratio). The serum and CSF levels were not significantly correlated for\r\nany of the pituitary hormones. Comparing preand postmenopausal women the CSF gonadotropin levels were slightly but nonsignificantly increased after menopause,\r\ndespite marked differences in the serum concentrations: CSF FSH 1.21 ?0.17U/L after vs 0.84? 0.4U/L before menopause, CSF LH 0.60? 0.047U/L after vs 0.43? 0.14U/L before\r\nmenopause. The CSF/ serum ratio for FSH markedly decreased after menopause (0.02?0.003 vs 0.22?0.11) although the effect did not reach statistical significance. The same\r\nwas true for CSF/serum LH ratio (0.026?0.005 vs 0.09?0.002). For none of the hormones studied the CSF levels correlated with age.\r\nConclusion. Pituitary hormones are normally found in the CSF at much lower levels than in the serum. The CSF hormonal\r\nconcentrations do not significantly correlate with the serum ones.

Background. Chronic inflammation is associated with different cancers, and is identified as a key pathogenic mechanism in ovarian cancer. The purpose of our study was to evaluate systemic inflammation markers, as predictive and prognostic factors, in ovarian cancer patients with initial surgical treatment. Subjects and Methods. We performed a retrospective study on 60 ovarian cancer patients with primary cytoreduction surgery, between 2010-2018, with a follow-up period of at least one year. We analyzed systemic inflammation markers and their correlations with the clinical, paraclinical, tumor characteristics, or treatment particularities, and evaluated them as prognostic factors for overall survival. Results. In the univariate analysis, no statistically significantly differences were observed, by correlating the systemic inflammation markers with age, reproductive status, FIGO stage, or type of cytoreduction. Higher neutrophillymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were statistically significant associated with deceased patients, and lower lymphocyte-monocyte ratio (LMR) had statistical significance for living patients. For the patients in the group, the increase of NLR, as well as of PLR leads to the increased risk of death, and the increase of LMR leads to the decrease of this risk. In the multivariate regression analysis, the increase of NLR determined an increased risk of death by 9.7%, and for LMR a reduced risk of death by 46.9%. Conclusions. Systemic inflammation markers had no statistical significance correlated with age, reproductive status, FIGO stage, serous cancer type, or type of cytoreduction but only with overall survival. NLR is an independent risk factor, while LMR is an independent protection factor as well as optimal cytoreduction.