评估生长激素腺瘤患者的甲状腺特征。
Evaluation of the thyroid characteristics of patients with growth hormone-secreting adenomas.
机构信息
Department of Neurosurgery, The First Affiliated Hospital, Jinan University, No. 613 Huangpu Avenue West, Tianhe District, Guangzhou 510632, Guangdong Province, 510630, People's Republic of China.
Department of Medical Ultrasound, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510632, China.
出版信息
BMC Endocr Disord. 2019 Sep 2;19(1):94. doi: 10.1186/s12902-019-0424-x.
BACKGROUND
Acromegaly is highly associated with thyroid disorders. However, the clinical characteristics of thyroid nodules in individuals with acromegaly who present with thyroid diseases have not been completely elucidated.
METHODS
Overall, 134 consecutive participants with growth hormone (GH)-secreting adenoma (n = 67) and non-functioning (NF) pituitary adenoma (n = 67) were recruited from the outpatient and inpatient patient department of The First Affiliated Hospital, Jinan University from August 2015 to August 2017. Thyroid ultrasonography was performed using an ultrasound system. The cytopathological results of fine-needle aspiration biopsy were analyzed by a pathologist according to the Bethesda system. Twenty-one patients with GH-secreting adenoma and thyroid disease underwent transsphenoidal pituitary adenoma resection and were followed up for 1 year.
RESULTS
The prevalence of thyroid disease increased in the GH-secreting adenoma group compared with that in the NF pituitary adenoma group. The number of hypoechoic, isoechogenic, heterogeneous, and vascular thyroid nodules increased in patients with GH-secreting adenoma plus thyroid disease compared with that in patients with NF pituitary adenoma plus thyroid disease. Finally, we found significant decreases in the morphology of solid nodules and significant increases in the morphology of cystic nodules after surgery compared with those before surgery in the cured group. Moreover, the numbers of heterogeneous and vascular thyroid nodules decreased significantly after surgery compared with those before surgery in the cured group. However, the characteristics of the thyroid nodules did not change after surgery compared with those before surgery in the non-cured group.
CONCLUSIONS
The numbers of hypoechoic, isoechoic, heterogeneous, and vascular thyroid nodules increased in patients with GH-secreting adenomas. In these patients, surgery resulted in significant changes from solid to cystic nodules and also reduced the numbers of heterogeneous and vascular thyroid nodules.
背景
肢端肥大症与甲状腺疾病高度相关。然而，患有肢端肥大症且患有甲状腺疾病的个体中甲状腺结节的临床特征尚未完全阐明。
方法
2015 年 8 月至 2017 年 8 月，从暨南大学第一附属医院门诊和住院患者中招募了 134 名连续的生长激素（GH）分泌腺瘤（n=67）和无功能（NF）垂体腺瘤（n=67）患者。使用超声系统进行甲状腺超声检查。病理学家根据 Bethesda 系统分析细针抽吸活检的细胞病理学结果。21 名 GH 分泌腺瘤合并甲状腺疾病患者接受经蝶窦垂体腺瘤切除术，并随访 1 年。
结果
与 NF 垂体腺瘤组相比，GH 分泌性腺瘤组甲状腺疾病的患病率增加。与 NF 垂体腺瘤合并甲状腺疾病患者相比，GH 分泌性腺瘤合并甲状腺疾病患者的低回声、等回声、不均匀和血管性甲状腺结节数量增加。最后，我们发现治愈组手术后实性结节的形态有明显改善，囊性结节的形态有明显增加，与手术前相比。此外，与手术前相比，治愈组手术后不均匀和血管性甲状腺结节的数量明显减少。然而，与手术前相比，未治愈组手术后甲状腺结节的特征没有变化。
结论
GH 分泌性腺瘤患者的低回声、等回声、不均匀和血管性甲状腺结节数量增加。在这些患者中，手术导致实性结节向囊性结节显著转变，并减少了不均匀和血管性甲状腺结节的数量。
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