Nilsson B, Gustavasson-Kadaka E, Bengtsson B A, Jonsson B
Department of Cancer Epidemiology, Karolinska University Hospital, Stockholm, Sweden.
J Clin Endocrinol Metab. 2000 Apr;85(4):1420-5. doi: 10.1210/jcem.85.4.6498.
The objective of the present study was to determine the incidence of pituitary adenomas (PAs) and the associated rates and causes of mortality in a large population. The study population comprised 2279 patients (1010 women and 1269 men) of all individuals (n = 3321) with pituitary tumors included in the Swedish Cancer Registry between 1958 and 1991. The mean age (+/-SD) at diagnosis was 52.3 +/-15.7 yr. The age-standardized incidence of PA increased significantly from approximately 6 cases/million inhabitants in 1958 to 11 cases/ million in 1991. The age-specific incidence peaked between 60-70 yr of age in both sexes. Excess mortality was found in the study population. The total number of deaths was 842. The standardized mortality ratio (SMR) for the study population was 2.0. The SMR for women (2.3) was significantly (P < 0.01) higher than that for men (1.9). Cardiovascular diseases were the most common cause of mortality among patients, accounting for 346 deaths (SMR, 1.6). The difference between the sexes was significant (men, 1.4; women, 1.8; P < 0.05). Cerebrovascular death occurred in 97 patients (SMR, 2.4), with no significant difference between men (SMR, 2.5) and women (SMR, 2.2). Excess mortality was also observed for tumors, endocrine diseases, and gastrointestinal diseases. These findings suggest that the annual incidence of PA is increasing. Possible explanations are improved diagnostic skill and/or increased awareness of pituitary diseases among physicians. However, a real increase in the incidence of PA cannot be ruled out.
本研究的目的是确定在一大群人中垂体腺瘤（PA）的发病率以及相关的死亡率和死亡原因。研究人群包括1958年至1991年间瑞典癌症登记处登记的所有垂体肿瘤患者（n = 3321）中的2279例患者（1010名女性和1269名男性）。诊断时的平均年龄（±标准差）为52.3±15.7岁。PA的年龄标准化发病率从1958年的约6例/百万居民显著增加到1991年的11例/百万。两性的年龄特异性发病率在60 - 70岁之间达到峰值。在研究人群中发现了超额死亡率。死亡总数为842例。研究人群的标准化死亡比（SMR）为2.0。女性的SMR（2.3）显著高于男性（1.9）（P < 0.01）。心血管疾病是患者中最常见的死亡原因，占346例死亡（SMR，1.6）。两性之间的差异显著（男性，1.4；女性，1.8；P < 0.05）。97例患者发生脑血管死亡（SMR，2.4），男性（SMR，2.5）和女性（SMR，2.2）之间无显著差异。在肿瘤、内分泌疾病和胃肠道疾病方面也观察到超额死亡率。这些发现表明PA的年发病率正在增加。可能的解释是诊断技术的提高和/或医生对垂体疾病认识的增加。然而，不能排除PA发病率的实际增加。
