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垂体肿瘤引起的肢端肥大症的精准治疗:它离现实有多近?

Precision Therapy in Acromegaly Caused by Pituitary Tumors: How Close Is It to Reality?

机构信息

Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Department of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.

出版信息

Endocrinol Metab (Seoul). 2020 Jun;35(2):206-216. doi: 10.3803/EnM.2020.35.2.206. Epub 2020 Jun 24.

Abstract

Acromegaly presents with an enigmatic range of symptoms and comorbidities caused by chronic and progressive growth hormone elevations, commonly due to endocrinologic hypersecretion from a pituitary gland tumor. Comprehensive national acromegaly databases have been appearing over the years, allowing for international comparisons of data, although still presenting varying prevalence and incidence rates. Lack of large-scale analysis in geographical and ethnic differences in clinical presentation and management requires further research. Assessment of current and novel predictors of responsiveness to distinct therapy can lead to multilevel categorization of patients, allowing integration into new clinical guidelines and reduction of increased morbidity and mortality associated with acromegaly. This review compares current data from epidemiological studies and assesses the present-day application of prognostic factors in medical practice, the reality of precision therapy, as well as its future prospects in acromegaly, with a special focus on its relevance to the South Korean population.

摘要

肢端肥大症表现为一系列复杂的症状和并存病症,这些症状和并存病症是由慢性和进行性生长激素升高引起的,通常是由于垂体肿瘤导致内分泌过度分泌。近年来,综合的肢端肥大症国家数据库不断出现,使得可以对数据进行国际比较,尽管患病率和发病率仍存在差异。在临床表型和治疗管理方面,缺乏针对地理和种族差异的大规模分析,需要进一步研究。评估当前和新型预测因子对不同治疗方法的反应性,可以对患者进行多层次分类,从而纳入新的临床指南,并降低与肢端肥大症相关的发病率和死亡率增加的风险。这篇综述比较了来自流行病学研究的现有数据,并评估了当前预测因素在医学实践中的应用、精准治疗的现状及其在肢端肥大症中的未来前景,特别关注其与韩国人群的相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/952a/7386101/7e059ec27ac3/enm-2020-35-2-206f1.jpg

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