库辛病的临床表型和瘤行为随年龄而变化:诊断和外科手术方面的影响
Jorge Eduardo Salcedo-Sifuentes1, Ryan Shih1, Anthony P Heaney2
1David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California.
The Journal of clinical endocrinology and metabolism
|January 2, 2025
概括
患有库辛病 (CD) 的老年患者表现出较少的经典症状,但更多的并发病和较大的瘤. 年龄影响CD呈现,瘤生物学和外科手术结果,需要量身定制的治疗方法.
科学领域:
- 内分泌学 在内分泌学.
- 神经外科 神经外科
- 在瘤学瘤学.
背景情况:
- 在老年人群中,库辛病 (CD) 的表现,瘤生物学和手术致病率仍然不太清楚.
- 对CD临床特征和结果的年龄相关差异需要进一步调查.
研究的目的:
- 评估年龄在库辛病的诊断和预后意义.
- 用大型多机构数据集分析CD呈现,实验室结果,瘤特征和术后结果的年龄相关差异.
主要方法:
- 从2003年到2023年期间,从下垂体腺瘤和相关疾病 (RAPID) 登记册 (RAPID) 中的数据的回顾性审查.
- 包括11个中心的跨瘤切除治疗的CD患者.
- 评估并发症,表现特征,内分泌评估,外科特征,术后实验室值和并发症.
主要成果:
- 年龄的增加与较高的并发病,虚弱,术后血栓栓塞性疾病,较高的Knosp等级,较大的瘤大小,以及术后皮质醇和ACTH nadirs的升高相关.
- 年长的患者表现出较少的特征CD特征,较低的手术前24小时尿液自由皮质醇,降低Ki-67指数,较少的氨酸压缩素缺乏.
- 较年轻的患者更频繁地呈现了经典的CD症状,如体重增加和疹症,而老年患者的阻塞性睡眠呼吸暂停和感染率更高.
结论:
- 在库辛病的临床表现,瘤行为和手术结果中存在显著的年龄相关变异.
- 老年患者呈现出较少经典的表型,并发症增加和较大的瘤,这表明瘤行为可能更惰,诊断延迟.
- 量身定制的诊断和治疗策略对于管理不同年龄组的库辛病至关重要,重点关注并发症和外科手术结果.
关键词:
库辛氏病是一种疾病.年长的老人老年人老年人.过高皮质醇主义是什么?pituitary 注册 pituitary 注册 pituitary 注册 pituitary 注册 pituitary 注册 pituitary 注册 pituitary 注册 pituitary 注册 pituitary 注册更多相关视频
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