[侵袭性垂体瘤和癌症:现代分类,治疗的进展和前景]
L I Astafyeva1, P L Kalinin1, G L Kobyakov1
1Burdenko Neurosurgical Center, Moscow, Russia.
Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko
|June 17, 2024
概括
对于侵袭性垂体神经内分泌瘤,需要新的预后标志物. 使用扩散和侵入性标记器的五阶段分类可以帮助早期检测这些具有挑战性的瘤.
科学领域:
- 内分泌学和神经瘤学
- 瘤的分类和预后.
背景情况:
- 垂体瘤虽然通常生长缓慢,但在10%的病例中可以表现出侵略性行为,高复发率和治疗阻力.
- 目前的世卫组织分类建议"垂体神经内分泌瘤"和"转移性垂体神经内分泌瘤",但缺乏积极亚型的有效预后标志物.
- 缺乏可靠的预后标志物使得侵袭性垂体瘤的早期诊断变得复杂.
研究的目的:
- 为切除的垂体瘤提出一个新的五阶段预后分类.
- 确定有效的预后标记,用于早期检测侵袭性垂体瘤和垂体癌.
- 为指导多学科的治疗策略,攻击性垂体瘤.
主要方法:
- 建议基于增殖标记的五阶段预后分类:线粒细胞计数,Ki-67指数和p53免疫表达.
- 在预后评估中包括侵袭性的形态标记.
- 对当前和替代治疗方法的审查,包括手术,放射治疗,体静止素类似物,多巴胺激动剂,特莫索洛米德,PRRT,向治疗和免疫治疗.
主要成果:
- 拟议的分类旨在促进早期检测侵袭性垂体瘤和垂体癌.
- 侵袭性瘤生长往往需要重复手术和放射治疗,因为压缩重要的大脑结构.
- 讨论了标准和替代疗法,强调了需要多学科的方法.
结论:
- 对于垂体瘤,建议采用五个阶段的预后分类,包括扩散和侵入性标记.
- 这种分类可以帮助早期识别攻击性瘤和垂体癌.
- 攻击性垂体瘤的管理需要多学科的团队方法和考虑先进的治疗方案.
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