在先进的丸非半形胚芽细胞瘤中发生的副瘤性甲状腺功能过敏症:流行率和临床管理
Markus Angerer1, Bendix Hansen1, Christian Wülfing1
1Department of Urology, Asklepios Hospital Altona, Hamburg, Germany.
Oncology
|May 6, 2024
概括
副发性甲状腺功能增强症 (PH) 影响0.7%的丸生殖细胞瘤 (GCT) 患者,特别是那些具有非常高β-人类胆性淋巴激素 (bHCG) 水平的患者. 早期识别和治疗PH可以改善结果,而不会影响GCT治疗.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 生殖医学 生殖医学
背景情况:
- 副发性甲状腺炎症 (PH) 是丸生殖细胞瘤 (GCTs) 的罕见并发症,与升高的β-人类胆性淋巴激素 (bHCG) 相关.
- 在GCT患者中PH的患病率和临床特征仍然不明.
- 这项研究旨在确定GCT患者PH的频率和临床特征,以及其对治疗结果的影响.
研究的目的:
- 在丸生殖细胞瘤 (GCT) 患者中调查副瘤性甲状腺功能障碍 (PH) 的相对频率.
- 描述GCT患者PH的临床特征.
- 评估PH对GCT患者治疗结果的影响.
主要方法:
- 在2017年至2023年期间接受治疗的438名丸GCT患者的回顾性分析.
- 评估患者的组织学,年龄,临床阶段和PH的存在.
- 临床特征的描述性分析和跨子组PH频率的统计比较.
主要成果:
- 三名患者 (队列的0.7%) 呈现PH,所有患者都有先进的,转移的,非种类型的GCT和非常高的bHCG水平 (225,0001,520,000U/L).
- 在bHCG.极度升高的患者中,PH患病率达到60%.
- 甲状腺静止剂治疗消除了甲状腺功能过高的症状,使TSH正常化,并且没有对GCT治疗结果产生负面影响.
结论:
- 副发性甲状腺功能增强症 (PH) 发生在0.7%的GCT患者中,但高达60%的患者患有非常高的bHCG.
- 对于预后不佳的GCT患者,建议对TSH和FT3进行监测.
- 及时诊断和对PH的静电治疗可以降低并发病率,并优化GCT患者的治疗结果.
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