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[内分泌肿瘤:临床概述]

[Endocrine tumors: clinical overview].

作者信息

Leidig-Bruckner G

机构信息

Gemeinschaftspraxis Endokrinologie & Nuklearmedizin, Brückenstr. 21, 69120, Heidelberg, Deutschland,

出版信息

Radiologe. 2014 Oct;54(10):966-74. doi: 10.1007/s00117-014-2687-6.

Abstract

The term endocrine tumor incorporates all neoplasms which originate from the various endocrine organs. Endocrine tumors can be characterized by different criteria: localization, endocrine function, dignity (i.e. tumorigenesis, sporadic or hereditary). These characteristics also determine the clinical outcome. The clinical history, symptoms and physical examination findings (e.g. amenorrhea, skin alterations, striae, virilization, increased blood pressure and flush) direct the diagnostic process of functioning endocrine tumors. Laboratory findings (endocrine parameters) are needed to establish a diagnosis supplemented by imaging for localization and special investigations (ophthalmological examination). In hereditary tumor syndromes, the familial history and molecular genetic testing and screening of family members are essential for establishing the diagnosis and achieve optimal and early treatment. Ideally, affected family members can be treated before clinical symptoms or metastatic disease occurs, improving outcome and prognosis. Incidentalomas are increasingly found due to widespread use of imaging techniques, especially in the thyroid, adrenal glands, pancreas and pituitary gland. In incidentalomas the functional status and risk of malignancy has to be evaluated as both parameters determine therapy decisions. The aim of this introductory article is to give an overview about particular features of endocrine tumors, clinical and related aspects for the diagnostic and therapeutic approach. The clinical features of tumors of the pituitary, parathyroid and adrenal glands and the gastroenteropancreatic system are summarized according to localization.

摘要

内分泌肿瘤这一术语涵盖了所有起源于各种内分泌器官的肿瘤。内分泌肿瘤可根据不同标准进行分类:定位、内分泌功能、性质(即肿瘤发生、散发性或遗传性)。这些特征也决定了临床结果。临床病史、症状和体格检查结果(如闭经、皮肤改变、条纹、男性化、血压升高和潮红)指导功能性内分泌肿瘤的诊断过程。需要实验室检查结果(内分泌参数)来辅助诊断,同时还需进行影像学检查以确定肿瘤位置,并进行特殊检查(眼科检查)。在遗传性肿瘤综合征中,家族病史以及对家庭成员进行分子遗传学检测和筛查对于确诊以及实现最佳的早期治疗至关重要。理想情况下,可在临床症状或转移性疾病出现之前对受影响的家庭成员进行治疗,从而改善治疗效果和预后。由于影像学技术的广泛应用,偶发瘤越来越多地被发现,尤其是在甲状腺、肾上腺、胰腺和垂体。对于偶发瘤,必须评估其功能状态和恶性风险,因为这两个参数决定了治疗方案。这篇介绍性文章的目的是概述内分泌肿瘤的特殊特征、临床以及诊断和治疗方法的相关方面。根据定位总结了垂体、甲状旁腺、肾上腺以及胃肠胰系统肿瘤的临床特征。

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