Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK.
1st Department of Propaedeutic Internal Medicine, Endocrine Unit, National and Kapodistrian, University of Athens, 11527, Athens, Greece.
Sci Rep. 2021 May 7;11(1):9801. doi: 10.1038/s41598-021-89256-7.
Prolactinomas represent the most common type of secretory pituitary neoplasms, with a therapeutic management that varies considerably based on tumour size and degree of hyperprolactinemia. The aim of the current study was to evaluate the relationship between serum prolactin (PRL) concentrations and prolactinoma size, and to determine a cut-off PRL value that could differentiate micro- from macro-prolactinomas. A retrospective cohort study of 114 patients diagnosed with prolactinomas between 2007 and 2017 was conducted. All patients underwent gadolinium enhanced pituitary MRI and receiver operating characteristic (ROC) analyses were performed. 51.8% of patients in this study were men, with a mean age at the time of diagnosis of 42.32 ± 15.04 years. 48.2% of the total cohort were found to have microadenomas. Baseline serum PRL concentrations were strongly correlated to tumour dimension (r = 0.750, p = 0.001). When performing the ROC curve analysis, the area under the curve was 0.976, indicating an excellent accuracy of the diagnostic method. For a value of 204 μg/L (4338 mU/L), sensitivity and specificity were calculated at 0.932 and 0.891, respectively. When a cut off value of 204 μg/L (4338 mU/L) was used, specificity was 93.2%, and sensitivity 89.1%, acceptable to reliably differentiate between micro- and macro- adenomas.
催乳素瘤是最常见的分泌性垂体肿瘤，其治疗管理因肿瘤大小和高催乳素血症程度而异。本研究旨在评估血清催乳素（PRL）浓度与催乳素瘤大小之间的关系，并确定一个区分微腺瘤和大腺瘤的 PRL 截止值。对 2007 年至 2017 年间诊断为催乳素瘤的 114 例患者进行了回顾性队列研究。所有患者均接受钆增强垂体 MRI 检查，并进行了受试者工作特征（ROC）分析。本研究中 51.8%的患者为男性，诊断时的平均年龄为 42.32±15.04 岁。总队列中有 48.2%的患者被发现为微腺瘤。基线血清 PRL 浓度与肿瘤大小呈强相关（r=0.750，p=0.001）。进行 ROC 曲线分析时，曲线下面积为 0.976，表明诊断方法具有极好的准确性。当 204μg/L（4338mU/L）为截断值时，灵敏度和特异性分别为 0.932 和 0.891。当使用 204μg/L（4338mU/L）的截断值时，特异性为 93.2%，灵敏度为 89.1%，可可靠地区分微腺瘤和大腺瘤。
