脑下垂体轴参与初级中枢神经系统淋巴瘤:一个系统性审查
Carolina Sager-La Ganga1, Víctor Navas-Moreno1, Fernando Sebastián-Valles1
1Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, Spain.
The Journal of clinical endocrinology and metabolism
|November 13, 2025
概括
主要中枢神经系统淋巴瘤 (PCNSL) 经常导致下丘脑-垂体轴 (HPA) 内分泌功能障碍,特别影响淋巴腺和甲状腺轴. 早期查和多学科护理对于管理这些未被认可的并发症至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 神经学 神经学
- 在瘤学瘤学.
背景情况:
- 主要中枢神经系统淋巴瘤 (PCNSL) 是一种影响大脑的罕见癌症.
- PCNSL可以影响下丘脑-垂体轴 (HPA),导致显著的内分泌问题.
- 这些内分泌功能障碍在PCNSL患者中经常被忽视.
研究的目的:
- 在PCNSL患者中系统地审查和描述与HPA相关的内分泌干扰.
- 确定受PCNSL影响最常见的模式和特定的荷尔蒙轴.
主要方法:
- 在主要数据库 (PubMed,EMBASE,Scopus,Web of Science) 进行了系统的文献搜索,截至2025年2月.
- 包括成年PCNSL病例,有记录的荷尔蒙轴功能障碍,不包括先前存在的下垂体病.
- 提取了有关人口统计,瘤位置,受影响轴,成像,治疗和结果的数据;评估了偏差风险.
主要成果:
- 分析了99例PCNSL病例,其中扩散型大B细胞淋巴瘤 (DLBCL) 占84%.
- 常见的功能障碍包括单独的腺细胞 (46%),神经细胞 (8%) 和联合 (45%) 的参与.
- 淋巴 (89.7%) 和甲状腺 (89.2%) 轴最受影响;下丘脑瘤与更广泛的功能障碍相关 (OR=9.47).
结论:
- HPA功能障碍是PCNSL的常见并未确诊的并发症.
- 脑下垂体的参与显著扩大了激素功能障碍的范围.
- 常规的激素查和综合的多学科护理对于最佳的PCNSL管理至关重要.
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