Plasma ACTH in patients with bronchogenic carcinoma

Immunoreactive ACTH before and five hours after administration of 2 mg of dexamethasone was determined in patients examined in hospital for abnormalities on chest X-ray. Thirty patients had primary bronchial cancer, 15 had other lung conditions, mostly inflammatory infiltrations. The mean total ACTH and ACTH after dexamethasone suppression were significantly higher in the patients with bronchial cancer than in patients with other lung lesions or healthy controls. ACTH in plasma after administration of glucocorticoids was predominantly big ACTH. Several of the cancer patients had, however, ACTH levels within the same range as the other subjects. These results indicate that plasma ACTH determinations are of limited value as tumour markers for the detection of lung cancer although it is still possible that repeated sampling in patients with elevated ACTH levels may be of value when monitoring the therapy.