Antidiuretic Hormone in Bronchogenic Carcinoma

Abstract

Immunoactive antidiuretic hormone (ADH) was measured by radioimmunoassay in the plasma, lung tumours and metastatic tumours of nineteen patients with bronchogenic carcinoma. Ten patients had hyponatraemia and carcinoma of the small oat cell type. Plasma ADH measured in nine of these patients ranged from 11--270 pg/ml and was elevated above the normal range (4.6--6.2 pg/ml) in all subjects. ADH-immunoreactive material was detectable in all primary lung tumours (range 9--1080 pg/mg wet weight, n = 7) and metastases (range 5--63 pg/mg wet weight, n = 9) obtained from the hyponatraemic patients. A statistical relationship existed between plasma and tumour ADH concentration in six patients where both measurements were performed. Three patients had small cell carcinomas (two oat cell and one anaplastic) without overt hyponatraemia. ADH-like material was detectable in the lung tumours (18 and 1.1 pg/mg wet weight) and liver metastases (4 and 1.0 pg/mg wet weight) of two patients but not in the third. Four of the remaining patients had squamous cell carcinomas and two had adenocarcinomas. None had hyponatraemia. ADH-like material was undetectable in all lung tumours, metastatic tumours and uninvolved tissue from these patients. ADH extracted from the pituitaries of four patients ranged from 6400--13200 pg/mg wet weight. ADH immunoreactive extracts of six lung tumours and nine metastases (all oat cell) showed the same pattern on elution from a Sephadex G-25 column. A large peak, which made up 65% of the total activity, was eluted in the same position as synthetic arginine vasopressin and contained comparable amounts of immunoreactive and bioactive ADH. Two smaller peaks (8 and 27% of total activity) were eluted in positions of higher molecular weight and contained more immunoreactive than bioactive ADH. In contrast, three of four pituitary extracts showed only a single peak which eluted in the same position as marker vasopressin.

Hyponatraemia in cancer: association with type of cancer and mortality

“…Patients with bronchogenic carcinoma and hyponatraemia have a higher level of plasma arginine vasopressin (AVP) (Morton et al . ). Other studies have shown that 10–15% of patients with small cell lung cancer have hyponatraemia and that 70% of those patients have elevated plasma AVP (Odell & Wolfsen ; List et al .…”

“…Again, the higher incidence of SIADH in patients with lung cancer (especially small cell subtype) is the common cause of hyponatraemia in this subtype of cancer (Berghmans et al 2000;Doshi et al 2012). Patients with bronchogenic carcinoma and hyponatraemia have a higher level of plasma arginine vasopressin (AVP) (Morton et al 1978). Other studies have shown that 10-15% of patients with small cell lung cancer have hyponatraemia and that 70% of those patients have elevated plasma AVP (Odell & Wolfsen 1978;List et al 1986;Shapiro & Richardson 1995).…”

Small cell lung carcinoma: Clinicopathological, immunohistochemical, and ultrastructural study

“…Our data do not indicate that chromogranin-A is a useful marker in the diagnosis of SCLA. (SIADH) are noted to be associated with such ectopic hormone production [105]. The SCLA may also be associated with the carcinoid syndrome resulting in the urinary excretion of excessive amounts of 5-hydroxyindole acidic acid (5-HIAA) or 5-hydroxytryptophan (5-HTP) .…”

Tumor-Related Hyponatremia

“…They postulated that the tumors led to the inappropriate release of ADH, later discovered to consist of AVP. This suggestion was later confirmed since immunoactive AVP has been noted to be elevated in plasma of patients with bronchogenic carcinoma, 24 as well as in patients with a cancer of the digestive tract. 25 Some tumors may actually demonstrate multiple hormone production and clinical and laboratory evidence of both the ectopic adrenocorticotropic hormone and ADH syndromes.…”