下垂体腺瘤的诊断和治疗:一篇综述
Nicholas A Tritos1,2, Karen K Miller1,2
1Neuroendocrine Unit, Massachusetts General Hospital, Boston.
JAMA
|April 25, 2023
概括
每1100人中就有1人患上下垂体腺瘤. 治疗方法各不相同,大多数是手术,
科学领域:
- 内分泌学和瘤学:专注于垂体腺瘤,它们的分类和临床表现.
背景情况:
- 下垂体腺瘤是来自下垂体细胞的新生体,大约影响1100人中的1人.
- 这些瘤分为功能性 (分泌激素) 或非功能性,并按大小分为宏腺瘤 (≥10毫米) 和微腺瘤 (<10毫米).
研究的目的:
- 审查垂体腺瘤的分类,临床表现和治疗.
- 强调内分泌和眼科评估对受影响的患者的重要性.
- 根据瘤类型和特征概述当前的一线治疗策略.
主要方法:
- 根据大小 (微腺瘤与宏腺瘤) 和功能 (功能与非功能) 进行垂体腺瘤分类.
- 临床表现的回顾,包括激素过分症候群和质量效应症状.
- 诊断评估的总结,包括内分泌评估和视野测试.
- 治疗方法的概述,区分医疗和外科干预.
主要成果:
- 功能性瘤包括前乳腺瘤 (53%),体育瘤 (12%) 和皮质瘤 (4%).
- 宏瘤可能导致视野缺陷 (18-78%),头痛 (17-75%) 和下垂体缺陷 (34-89%).
- 非功能性腺瘤占 pituitary 瘤的 30%.
结论:
- 甲状腺瘤的第一线治疗是药物治疗 (布罗莫克里普丁或卡伯戈林).
- 通过状垂体手术是其他需要干预的垂体腺瘤的主要治疗方法.
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