非功能性垂体小腺瘤的自然史:系统性审查和个人参与者数据元分析
Victor B Boesen1, Tue H Hansen1,2, Mohammad Motawea1
1Clinic for Pituitary Disorders, Department of Medicine, Zealand University Hospital, 4600 Køge, Denmark.
European journal of endocrinology
|September 22, 2025
概括
对于小非功能性垂体腺瘤 (NFPAs) 的例行随访可能会减少. 微NFPA的保守管理表明手术或新的内分泌病变的风险较低,建议修订指南.
科学领域:
- 内分泌学 在内分泌学.
- 神经外科 神经外科
- 放射学 放射学是一门学科.
背景情况:
- 增加神经成像检测到更多的小非功能性垂体腺瘤 (NFPA).
- 对偶然发现的微型NFPA进行广泛跟踪的必要性是不确定的.
- 评估与保守管理相关的风险至关重要.
研究的目的:
- 确定对保守治疗的微型NFPA进行手术的必要性.
- 在随访期间评估发展新的内分泌病变的风险.
- 根据临床指导方针来管理偶然的垂体病变.
主要方法:
- 系统审查和个人参与者数据 (IPD) 的元分析.
- 在PubMed和EMBASE的文献搜索相关的队列研究.
- 从14项研究中重新分析了647名IPD患者的IPD.
主要成果:
- 手术的可能性低 (0.2/100人/年),包括视力障碍 (0.1/100人/年).
- 手术风险独立于瘤大小,性别或年龄.
- 新发生内分泌病的风险为1.0/100人年.
- 对1089名患者的经典元分析证实了IPD的发现.
结论:
- 微型NFPA的常规后续检查可能会减少.
- 目前管理偶发性垂体腺瘤的指导方针可能需要修订.
- 保守的管理似乎安全有效的选择微NFPAs.
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