Mallea-Gil Maria Susana, Manavela Marcos, Alfieri Analia, Ballarino Maria Carolina, Chervin Alberto, Danilowicz Karina, Diez Sabrina, Fainstein Day Patricia, García-Basavilbaso Natalia, Glerean Mariela, Guitelman Mirtha, Katz Débora, Loto Monica Graciela, Martinez Marcela, Miragaya Karina, Moncet Daniel, Rogozinski Amelia Susana, Servidio Marisa, Stalldecker Graciela, Vitale Marcelo, Boero Laura
Departamento de Neuroendocrinología (Neuroendocrinology Department), Sociedad Argentina de Endocrinología y Metabolismo, Ciudad Autónoma de Buenos Aires, Argentina.
Arch Endocrinol Metab. 2016 Feb;60(1):42-6. doi: 10.1590/2359-3997000000138.
The aim was to assess the evolution of tumor size and prolactin (PRL) levels in patients with micro and macroprolactinomas diagnosed and treated with dopamine agonists during fertile age, and the effects of suspension of drugs after menopause.
Retrospective study, 29 patients with prolactinomas, 22 microadenomas and 7 macroadenomas, diagnosed during their fertile age were studied in their menopause; treatment was stopped in this period. Age at menopause was 49 ± 3.6 years. The average time of treatment was 135 ± 79 months. The time of follow-up after treatment suspension was 4 to 192 months. Results: Pre-treatment PRL levels in micro and macroadenomas were 119 ± 57 ng/mL and 258 ± 225 ng/mL, respectively. During menopause after treatment suspension, and at the latest follow-up: in microadenomas PRL levels were 23 ± 13 ng/mL and 16 ± 5.7 ng/mL, respectively; in macroadenomas, PRL levels were 20 ± 6.6 ng/mL 5t5and 25 ± 18 ng/mL, respectively. In menopause after treatment suspension, the microadenomas had disappeared in 9/22 and had decreased in 13/22. In the group of patients whose tumor had decreased, in the latest follow-up, tumors disappeared in 7/13 and remained unchanged in 6/13. In macroadenomas, after treatment suspension 3/7 had disappeared, 3/7 decreased and 1/7 remained unchanged. In the latest control in the 3 patients whose tumor decreased, disappeared in 1/3, decreased in 1/3 and there was no change in the remaining.
Normal PRL levels and sustained reduction or disappearance of adenomas were achieved in most of patients, probably due to the decrease of estrogen levels. Dopamine agonists might be stopped after menopause in patients with prolactinomas.
评估在育龄期诊断并接受多巴胺激动剂治疗的微泌乳素瘤和大泌乳素瘤患者的肿瘤大小及催乳素（PRL）水平的变化情况，以及绝经后停药的影响。
一项回顾性研究，对29例泌乳素瘤患者进行研究，其中22例为微腺瘤，7例为大腺瘤，这些患者在育龄期被诊断，研究其绝经后的情况；在此期间停止治疗。绝经年龄为49±3.6岁。平均治疗时间为135±79个月。停药后的随访时间为4至192个月。结果：微腺瘤和大腺瘤治疗前的PRL水平分别为119±57 ng/mL和258±225 ng/mL。在停药后的绝经期间以及最近一次随访时：微腺瘤的PRL水平分别为23±13 ng/mL和16±5.7 ng/mL；大腺瘤的PRL水平分别为20±6.6 ng/mL和25±18 ng/mL。在停药后的绝经期间，22例微腺瘤中有9例消失，13例缩小。在肿瘤缩小的患者组中，在最近一次随访时，13例中有7例肿瘤消失，6例保持不变。在大腺瘤中，停药后7例中有3例消失，3例缩小，1例保持不变。在最近一次检查中，3例肿瘤缩小的患者中，1例消失，1例缩小，其余1例无变化。
大多数患者实现了PRL水平正常以及腺瘤持续缩小或消失，这可能归因于雌激素水平的降低。泌乳素瘤患者在绝经后可能停用多巴胺激动剂。
