プロラクチン分泌腺腫:病原性,診断,治療
Maria Fleseriu1, Elena V Varlamov1, Amit Akirov2
1Pituitary Center, Oregon Health and Science University, Portland, OR, USA; Department of Neurological Surgery and Department of Medicine, Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University, Portland, OR, USA.
The lancet. Diabetes & endocrinology
|August 28, 2025
まとめ
低垂体腺腫によって引き起こされる高プロラクチネミアは,カベルゴリンのようなドーパミンアゴニストで効果的に治療され,プロラクチンレベルを正常化し,腫瘍を縮小させます. 手術は小さな腺腫や 薬が効かない場合の 寛解をもたらします
科学分野:
- 内分泌学
- 腫瘍学
- 神経外科
背景:
- 甲状腺腺腫を含む生理学的,薬理学的,または病理学的原因に起因する.
- プロラクチン分泌性下垂体腺腫 (プロラクチノーマ) は,最も一般的な機能性下垂体腫瘍で,男性と女性の特徴が異なっている.
- 診断には,プロラクチン,下垂体特異的陽性転写因子1およびエストロゲン受容体αに対する免疫染色が含まれます.
研究 の 目的:
- プロラクチノーマの病原性,診断,治療について見直す.
- 現在の治療戦略を評価し,将来の研究方向性を特定する.
主な方法:
- プロラクティノーマの病原性,診断,治療に関する文献レビュー.
- ドーパミンアゴニスト,手術,放射線療法の治療結果の分析
主要な成果:
- ドーパミンアゴニスト,特にカベルゴリン (最大2. 0 mg/週) は,プロラクチンを正常化し,腫瘍を縮小させ,ほとんどの患者で6ヶ月以内に性腺機能を回復させます.
- トランスフェノイド手術は小型のプロラクティノーマの寛解率を高く,薬物不耐性または耐性症例の選択肢です.
- 放射線治療は耐性プロラクチノーマに限られています.
結論:
- 複数の分野にまたがって 個別化された治療法により プロラクチノーマの治療結果が最適化されます
- ドーパミンアゴニストと外科手術が主治療法であり,耐火性の症例では放射線治療が用いられる.
- プロラクティノーマの治療を進めるためにさらなる研究が必要である.
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