Evidence map›Paper›PMID 37354283›Full record

ArticleEndocrine2023

Role of adrenal venous sampling in the differential diagnosis and treatment protocol of ACTH-independent Cushing's syndrome with bilateral adrenal lesions.

Xingxing An, Tao Chen, Dan Mo, Sikui Shen, Dan Zhang, Tingting Zhang, Haoming Tian, Yuanmei Li, Jianwei Li, Li Li and 3 more

Abstract read
PubMed Publisher
In one paragraph

Article in Endocrine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.6field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Review
  3. Kangbo Knife Cryoablation for the Treatment of Functional Adrenal Tumors.Clinical medicine insights. Endocrinology and diabetes · 2025
    Article
  4. Selective venous sampling for secondary hypertension.Hypertension research : official journal of the Japanese Society of Hypertension · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 1 country.

Xingxing An *Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
Tao Chen *Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
Dan MoChinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
Sikui ShenDepartment of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
Dan ZhangDepartment of Endocrinology and Metabolism, Tibet Branch of West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
Tingting ZhangHealth Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
Haoming TianDepartment of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
Yuanmei LiDepartment of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
Jianwei LiDepartment of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
Li LiInstitute of Clinical Pathology, West China Hospital of Sichuan University, Chengdu, 610041, China.
Nianwei WuDepartment of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
Yuchun ZhuDepartment of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China. mmaalleee@126.com.
Yan Ren *Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China. renyan@scu.edu.cn.
Sichuan University · CNWest China Hospital of Sichuan University · CN

Funding

Key Technologies Research and Development Program 2021YFC2501600Sichuan Province Science and Technology Support Program 23ZDYF2116West China Hospital, Sichuan University 2021HXFH008
6 · The paper itself

Abstract

purposeThe diagnosis and management of adrenocorticotropic hormone-independent Cushing's syndrome (AICS) with bilateral adrenal lesions remain challenging. Some studies have explored the value of adrenal vein sampling (AVS) in patients with AICS; however, more investigations are needed to assess its benefits for diagnosis and treatment planning in this population.

methodsThirteen patients with clinical, biochemical and imaging evidence of AICS with bilateral adrenal lesions underwent AVS in our department from 2017-2022 were recruited. Only the data from nine patients for whom AVS succeeded were finally included in this study and further analyzed. Blood samples were successfully collected from both adrenal veins (AV) and inferior vena cava (IVC) in these nine patients, and the levels of plasma total cortisol (PTC) and plasma aldosterone concentrations (PAC) were measured. The ratio of the PAC of the AV to the IVC was calculated, and the PTC to PAC ratios were compared between AV. The surgical strategy was chosen according to the results of AVS. Postoperative histology and immunohistochemistry of the adrenal tissues were performed. The prognosis was evaluated based on the improvement of clinical symptoms and biochemical parameters (including PTC and ACTH measurements).

resultsPatients with AICS were clinically diagnosed based on clinical signs, results of functional tests and the presence of bilateral adrenal lesions as observed on computed tomography imaging. An AV to IVC PAC ratio greater than 2 confirmed successful AVS. The PTC to PAC ratio (high side to low side) was greater than 2 in four patients, and less than 2 in five patients. The postoperative pathological results were consistent with clinical diagnosis and AVS. During the mean follow-up of 33 months, all nine patients achieved varying degrees of clinical improvement.

conclusionOur study showed that AVS helped to distinguish unilateral and bilateral lesions, identify the laterality of the autonomous hypercortisolism, and improve therapeutic strategy selection in patients with AICS and bilateral adrenal lesions.

Indexed as

Cushing SyndromeHyperaldosteronismAdrenal GlandsAdrenocorticotropic HormoneAldosteroneClinical ProtocolsDiagnosis, DifferentialHumansHydrocortisoneRetrospective StudiesAdrenocorticotropic HormoneAldosteroneHydrocortisoneACTH-independent Cushing’s syndrome (AICS)Adrenal vein sampling (AVS)Bilateral adrenal lesionsDifferential diagnosisTreatment protocol

Identifiers

PMID37354283
OpenAlexW4381857199

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.