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男性泌乳素瘤的外科治疗:184例回顾性研究。

Surgical treatment for male prolactinoma: A retrospective study of 184 cases.

作者信息

Song Yi-Jun, Chen Mei-Ting, Lian Wei, Xing Bing, Yao Yong, Feng Ming, Wang Ren-Zhi

机构信息

Department of Neurosurgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.

出版信息

Medicine (Baltimore). 2017 Jan;96(2):e5833. doi: 10.1097/MD.0000000000005833.

DOI:10.1097/MD.0000000000005833
PMID:28079813
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5266175/
Abstract

A total of 184 cases of surgically treated male prolactinoma were analyzed retrospectively to summarize the outcome of this surgical intervention. We analyzed the general characteristics, clinical manifestations, hormone levels, imaging features, preoperative treatments, surgical outcomes, pathology results, and follow-up records for all included patients. The most common clinical manifestations included sexual dysfunction (47.4%), headache (55.9%), and visual disturbance (46.7%). Serum prolactin levels ranged from 150 to 204,952 ng/mL. Tumor size varied from 6 to 70 mm. Pituitary adenomas grew in a parasellar pattern with visual deficits occurring 40.7% of the time. After surgical therapy, 88.6% of patients achieved symptom relief, and 98.4% experienced an immediate postoperative decline in prolactin level. Fifty-seven patients (31.0%) achieved initial remission, and 26 patients (45.6%) experienced recurrence. Hence, our results suggest that in male prolactinoma characterized by a large pituitary diameter and high serum prolactin level, tumor size predicts the degree of gross resection. The prognostic predictors included preoperative tumor growth pattern and Ki-67 index.Citation: Yi-jun S, Mei-ting C, Wei L, Bing X, Yong Y, Ming F, Ren-zhi W. (2016) Surgical treatment for male prolactinoma: a retrospective study of 184 cases.

摘要

对184例接受手术治疗的男性泌乳素瘤患者进行回顾性分析,以总结该手术干预的结果。我们分析了所有纳入患者的一般特征、临床表现、激素水平、影像学特征、术前治疗、手术结果、病理结果及随访记录。最常见的临床表现包括性功能障碍(47.4%)、头痛(55.9%)和视觉障碍(46.7%)。血清泌乳素水平在150至204,952 ng/mL之间。肿瘤大小在6至70 mm之间。垂体腺瘤呈鞍旁生长模式,40.7%的患者出现视觉缺陷。手术治疗后,88.6%的患者症状缓解,98.4%的患者术后泌乳素水平立即下降。57例患者(31.0%)达到初始缓解,26例患者(45.6%)复发。因此,我们的结果表明,在以垂体直径大、血清泌乳素水平高为特征的男性泌乳素瘤中,肿瘤大小可预测大体切除程度。预后预测因素包括术前肿瘤生长模式和Ki-67指数。引用:易军S,美婷C,魏L,冰X,勇Y,明F,任志W。(2016年)男性泌乳素瘤的手术治疗:184例回顾性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f24/5266175/4c9d7b6e5ef4/medi-96-e5833-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f24/5266175/b0f6e9a602a7/medi-96-e5833-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f24/5266175/4c9d7b6e5ef4/medi-96-e5833-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f24/5266175/b0f6e9a602a7/medi-96-e5833-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f24/5266175/4c9d7b6e5ef4/medi-96-e5833-g002.jpg

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Eur J Endocrinol. 2015 Nov;173(5):655-64. doi: 10.1530/EJE-15-0189.
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Dopamine agonist therapy for prolactinomas: do we need to rethink the place of surgery in prolactinoma management?多巴胺激动剂治疗泌乳素瘤:我们是否需要重新思考手术在泌乳素瘤管理中的地位?
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