Plasma ACTH precursors measured by proopiomelanocortin ELISA as a predictor of silent corticotroph adenomas
Authors' conclusion
We found plasma POMC level to be a promising predictor of SCA presence in a CNFPA cohort.
Study context
- Population
- Patients with clinically non-functioning pituitary adenomas (157 treated surgically, 107 observed without surgery), plus 10 known silent corticotroph adenomas (SCAs) and 3 patients with Cushing disease (CD)
- Participants
- 264 clinically non-functioning pituitary adenoma (CNFPAs)
- Comparison
- Plasma POMC in SCA vs Not SCA among CNFPAs
- SCAn = 7
- Not SCAn = 138reference
- Outcome
- Plasma POMC level (2-site ELISA detecting POMC and pro-ACTH, not ACTH) as predictor of SCA; elevated ≥ 39 fmol/mL
Performance
As reported in the abstract
Plasma POMC
| Test or model | Value | Elevated POMC (≥ 39 fmol/mL) |
|---|---|---|
| SCA | median 73 fmol/mL | 85.7% |
| Not SCA | median 14 fmol/mL |
Value
SCAmedian 73 fmol/mL
Not SCAmedian 14 fmol/mL
Elevated POMC (≥ 39 fmol/mL)
SCA85.7%
Not SCA— not stated in the abstract
- SCA vs Not SCA: P < 0.001
- Elevated POMC predicting SCA among CNFPAs: sensitivity
- 85.7%
- Elevated POMC predicting SCA among CNFPAs: specificity
- 97.9%
Further findings
- POMC elevated in all known SCAs with visible residual tumor; range
- 49.6 to 3796 fmol/mL
Original publication
Plasma ACTH precursors measured by proopiomelanocortin ELISA as a predictor of silent corticotroph adenomas. J Clin Endocrinol Metab. Published 25 August 2026. doi:10.
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