Melmed S, Braunstein G D, Chang R J, Becker D P
Ann Intern Med. 1986 Aug;105(2):238-53. doi: 10.7326/0003-4819-105-2-238.
The pathophysiology of functional adenomas of the anterior pituitary gland can be understood in the context of the central neural control of anterior pituitary secretion and by the fact that the cell types of the anterior pituitary gland generally express a single polypeptide hormone. Functional pituitary adenomas arise de novo from one or more of these cell types, but a defect in hypothalamic regulation can contribute to tumorigenesis and sometimes result in persistent tumor recurrence despite local surgical cure. The recent advances in molecular biology, radioimmunoassay, neuroradiology, and transsphenoidal microneurosurgery techniques have greatly improved our understanding of the pathophysiology of these tumors, enhanced diagnostic accuracy, and led to newer medical and surgical therapeutic approaches. This conference reviews the molecular and cellular pathophysiology, causes, diagnosis, clinical features, and medical and surgical management of the two common functional pituitary adenomas, prolactinoma and somatotropinoma.
垂体前叶功能性腺瘤的病理生理学可结合垂体前叶分泌的中枢神经控制以及垂体前叶细胞类型通常仅表达单一多肽激素这一事实来理解。功能性垂体腺瘤起源于这些细胞类型中的一种或多种,但下丘脑调节缺陷可促成肿瘤发生,有时即便局部手术治愈仍会导致肿瘤持续复发。分子生物学、放射免疫测定、神经放射学和经蝶窦显微神经外科技术的最新进展极大地增进了我们对这些肿瘤病理生理学的理解,提高了诊断准确性,并催生了更新的药物和手术治疗方法。本次会议回顾了两种常见功能性垂体腺瘤——泌乳素瘤和生长激素瘤的分子与细胞病理生理学、病因、诊断、临床特征以及药物和手术治疗。