治疗与MEN1相关的内分泌瘤:三个系统性审查和一个元分析
Katherine A English1, Carolina R C Pieterman2, Francesca Marini3
1Academic Endocrine Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
部分甲状腺切除术减少了MEN1患者甲状腺功能障碍症复发的发生. 积极监测可能与小胰腺瘤的手术相匹配. 多巴胺激动剂对MEN1中的益生菌瘤有效.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 遗传学 是一个遗传学.
背景情况:
- 多重内分泌瘤1型 (MEN1) 是一种罕见的遗传性疾病.
- MEN1的特征是副甲状腺,胰腺和垂体瘤.
- 目前的MEN1治疗方法的证据有限.
研究的目的:
- 评估MEN1中原发性副甲状腺功能障碍症的治疗结果.
- 为了比较手术与非功能性胰腺神经内分泌瘤 (≤2厘米) 的积极监测在男性1.1.
- 评估在MEN1患者与非MEN1患者中治疗前乳腺瘤的多巴胺激动剂疗效.
主要方法:
- 进行了三次系统性审查和一个元分析.
- 在2001年12月至2023年2月期间,搜索了四个数据库 (MEDLINE,Embase,Cochrane,Web of Science).
- 包括随机对照试验,队列研究和病例系列;使用风险比率和平均差异评估结果.
主要成果:
- 部分甲状腺切除术显著降低了甲状腺功能障碍症的复发 (RR 0.78),但增加了甲状腺功能障碍症的风险 (RR 2.64).
- 对于小胰腺瘤,手术和积极监测显示出可比的转移和死亡率.
- 在MEN1患者和非MEN1患者中,多巴胺激动剂治疗前性瘤的失败率相似.
结论:
- 副全额甲状腺切除术在MEN1中对原发性甲状腺功能障碍症更有效.
- 积极监测可能是小的,非功能性胰腺神经内分泌瘤的手术的可行替代方案.
- 多巴胺激动剂在MEN1个体和非MEN1个体的益生菌瘤中表现出相似的疗效.
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