Biochemical and clinical studies of melatonin secretion of the brain tumors in pineal region.

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The changes in daytime levels of melatonin (MLT) in the cerebrospinal fluid (CSF) of twenty seven hydrocephalic patients were studied by the high-performance liquid chromatiography (HPLC) method. Patients comprised three with congenital hydrocephalus (spina bifida 1, Chiari type II malformation 2), four postmeningitic hydrocephalus, fifteen brain tumors (chiasmal germinoma 3 ; malignant glioma of frontal 3, and temporal lobes 1 ; germinoma 1, teratoma 2, yolk sac tumor 1, epidergerminoma 1, teratoma 2, yolk sac tumor 1, epidermoid 1 in pineal region) and five cases of normal pressure hydrocephalus. CSF was collected between 0930 and 1030h through puncture of the flushing device of shunt systm or the lateral ventricle. The lowest value of MLT detected by HPLC was 15 pg/ml.Melatonin values were higher in patients aged under 10 years than over 20 years in the absence of meningitis or tumor in the pineal region. Even at ages over 15 years, higher CSF MLT values were obtained in the patient … More s with meningitis or tumors in the pineal region. These results suggest that the inflammation or invasion of tumor into the pineal gland may stimulate the secretion of MLT by the pineal gland. However, lower MLT values were obtained in all patients over 40 years old. For these reasons, if one may use the changes of MLT values in CSF as a tumor maker or for determination of the treatment modality, time of CSF collection, age of meningitis should be given due consideration.Also, the presence or absence of the rhythmical changes of melatonin values in a day following circadian rhythm are very important in determination of the treatment modality.Melatonin values in cerebrospinal fluid (CSF) or serum of the pineal cell tumor (PCTS) patients do not always indicate the presence of PCT, and sometimes they go up in presence of the pineal stimulation by the gliomas or GCTs in and around the pineal gland. On the other hand, the histological diagnosis of GCTs and PCTs is sometimes very difficult on hematoxylin and eosin (HE) stained tissue. There are many tumors markers for GCTS, however, the tumor marker of PCTs has not yet been clarified. We studied whether melatonin is a specific tumor marker of PCTs or not using indirect immunocytochemical technique. PCT specimens stained positive with pineoblastoma cell showing higher positivity than pineocytoma cell. However, lower positivity was seen in older tissues of pineoblastoma. No positive stain was seen in all of the GCTs and control specimens. In the specimens of normal pineal glands, the positivity ratio was higher in adult than in the infant.In summary, melatonin is a useful tumor marker of PCTs and immunohistochemical staining for melatonin is a reliable examination for differential diagnosis of PCTs and other tumors. Less