pituitary macroadenomas (PitNets) 的临床和预后影响分级:一个单心经验
F Ferraù1,2, G Giuffrida1, R Casablanca2
1Department of Human Pathology of Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy.
Pituitary
|March 14, 2025
概括
特鲁伊拉斯分类系统有助于预测垂体神经内分泌瘤 (PitNets) 的结果. 瘤入侵影响结果,而Ki-67指数影响这些垂体腺瘤的手术成功.
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:
- 垂体神经内分泌瘤 (PitNets),或垂体腺瘤,可能是侵略性的治疗反应不佳.
- 缺少PitNet攻击性的预测参数.
- 2018年由Trouillas等人编制的5级分类. 需要进一步验证.
研究的目的:
- 调查Trouillas分类系统与PitNet特征之间的相关性.
- 评估这种分类与患者结局之间的关系.
- 为了评估这个分级系统在单心PitNet系列中的实用性.
主要方法:
- 88名患有 pituitary macroadenomas (功能和非功能) 的患者的回顾性评估.
- 在诊断和随访时审查人口统计,临床,放射学,生化和视觉场数据.
- 使用Trouillas分级系统对PitNets进行分类,并与临床病理和荷尔蒙特征相关联.
主要成果:
- 瘤等级1a和2a显示出更好的手术反应.
- 2a级的瘤与更频繁的全垂体瘤和视野变化有关.
- 对于2a和2b等级,CyberKnife放射治疗更为常见.
- Ki-67与功能性PitNets中的持久性疾病相关;入侵与非功能性PitNets中的残留存在相关.
结论:
- 侵袭性和不那么多的PitNets (2a级) 显示出更多的脑垂体功能和视野受损.
- 较少增殖的瘤 (等级1a和2a) 对手术反应更好.
- 瘤入侵会影响临床生物化学结果,而Ki-67会影响大型PitNets的手术结果.
相关概念视频
01:17The Pituitary Gland
The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.
01:26Cushing Syndrome I: Introduction
Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...
01:19Cushing Syndrome II: Pathophysiology
Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...