用多巴胺激动剂治疗的分泌前素的垂体神经内分泌瘤:反应的预测因素
Chiara Mele1, Marco Zavattaro1, Rosa Pitino1
1Endocrinology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
Frontiers in endocrinology
|September 25, 2025
概括
益生素 (PRL) 水平的早期正常化预测了在垂体腺瘤中对多巴胺激动剂 (DA) 的长期反应. 结合瘤直径和体积评估,可以改善对这些PRL分泌瘤的治疗监测.
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:
- 预测对前素 (PRL) 分泌 pituitary adenomas (PitNETs) 的多巴胺激动剂 (DA) 的反应缺乏确定的标准.
- 目前没有DA电阻的通用定义.
- 这项研究研究了在PitNETs中预测DA治疗的荷尔蒙和放射反应的因素.
研究的目的:
- 分析与DA治疗的PRL分泌PitNETs患者的临床,激素和放射性特征.
- 为了确定激素和放射反应对医疗治疗的预测因素.
- 在PitNET中建立DA抗性的标准.
主要方法:
- 对62名患者进行了20年 (2004-2024) 的回顾性队列研究.
- 在诊断和随访时收集的数据 (6,12,24个月,最后一次访问).
- DA抵抗定义为无法使PRL正常化并实现≥50%的瘤大小 (直径或体积) 减少.
主要成果:
- 早期PRL正常化预测了长期的荷尔蒙反应 (OR=11.29).
- 雄性巨乳瘤在具有较高基线PRL的男性中更为频繁.
- 基于直径的瘤评估在早期是有效的;体积后来变得更准确.
结论:
- PRL水平的正常化是治疗反应的可靠预测指标.
- 建议将直径和体积的综合评估用于放射性评估.
- 对于持久性疾病,应考虑使用手术等替代策略.
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