下垂体腺腫 の 診断 と 治療: レビュー
1Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
JAMA
|February 8, 2017
まとめ
低垂体腺腫の早期診断は 効果的な治療に不可欠です プロラクチノーマは典型的にはドーパミンアゴニストで治療されますが,他のアデノーマはしばしば手術が必要です.
科学分野:
- 内分泌学
- 神経外科
- 腫瘍学
背景:
- 下垂体腺腫は,流行度が異なる一般的な腫瘍です.
- ホルモンの過剰分泌や 質量効果を引き起こし 健康に悪影響を及ぼします
- 早期発見と治療は 患者の健康に不可欠です
研究 の 目的:
- 各種の下垂体腺腫の診断と治療を要約します
- 早期発見と介入の重要性を強調する
- アデノマの種類に基づいて現在の治療戦略を概説する.
主な方法:
- pituitary adenoma の流行,タイプ,および臨床表現のレビュー
- ホルモンレベル測定と画像検査を含む診断方法の記述
- 治療方法の概要:手術,医療療法,放射線療法
主要な成果:
- プロラクチノーマ (32~66%) はドーパミンアゴニストで治療されます.
- GHを分泌する腫瘍 (8 - 16%) は,最初は手術で治療され,しばしば治療が必要でした.
- ACTHを分泌する腫瘍 (2~6%) は,手術とクッシング病の薬剤で管理されます.
- 非機能性アデノマ (15~54%) は通常,質量効果のために手術を必要とします.
結論:
- 低垂体腺腫の早期診断は効果的な治療を可能にします.
- ドーパミンアゴニストは,プロラクチノーマの主要な治療法です.
- トランスフェノイド外科手術は,他のほとんどの下垂体腺腫の初期治療法であり,治療の選択肢は反応しない者に留まっています.
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