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孕激素作为导致肝细胞腺瘤的一个因素:病例系列和文献综述
Dehlia Moussaoui1, Sonia R Grover2
1Department of Paediatric and Adolescent Gynaecology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
孕激素的使用,特别是诺雷丁 (NET),与肝细胞腺瘤 (HA) 的发展有关. 停止使用NET或切换到其他孕激素可能会导致HA溶解,这表明存在因果关系.
科学领域:
- 肝病学和内分泌学.
- 生殖医学 生殖医学
背景情况:
- 肝细胞腺瘤 (HA) 是一种罕见的肝脏瘤.
- 孕激素在HA发育中的作用尚未完全理解.
研究的目的:
- 调查孕激素使用与肝细胞腺瘤 (HA) 之间的关联.
- 描述使用诺雷丁 (NET) 的年轻人中HA的病例,并审查现有文献.
主要方法:
- 在NET上有3名HA患者的病例系列.
- 对孕激素相关的HA病例进行了全面的文献综述.
主要成果:
- 自1983年以来,报告了16例与孕激素相关的HA病例,10例是NET或其前药物.
- 在8名患者中有7名患者中,激素停止导致HA大小减少或完全消失.
- 两名接受NET治疗的患者在转换为其他孕激素或停止接受NET治疗后经历了HA分离.
结论:
- 孕激素暴露,特别是NET及其前药物,与HA的发展有关.
- 病理生理学可能涉及转化为乙inyl estradiol或19-nortestosterone衍生物的直接作用.
- 像17-基孕这样的替代性孕激素可能是更安全的选择.
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