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一家三级中心关于肢端肥大症患者中良性和恶性肿瘤的经验。

The Experience of a Single Tertiary Center Regarding Benign and Malignant Tumors in Acromegalic Patients.

机构信息

2nd Department of Internal Medicine-Discipline of Endocrinology, "Victor Babes" University of Medicine and Pharmacy Timisoara, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania.

Department of Endocrinology, County Emergency Hospital Timisoara, Blvd. Liviu Rebreanu 156, 300723 Timisoara, Romania.

出版信息

Medicina (Kaunas). 2023 Jun 15;59(6):1148. doi: 10.3390/medicina59061148.

DOI:10.3390/medicina59061148
PMID:37374352
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10300720/
Abstract

Acromegaly is a rare disease associated with increased levels of growth hormones (GHs) that stimulates the hepatic production of insulin growth factor-1 (IGF-1). Increased secretion of both GH and IGF-1 activates pathways, such as Janus kinase 2/signal transducer and activator of transcription 5 (JAK2/STAT5), and mitogen-activated protein kinase (MAPK), involved in the development of tumors. Given the disputed nature of the topic, we decided to study the prevalence of benign and malignant tumors in our cohort of acromegalic patients. In addition, we aimed to identify risk factors or laboratory parameters associated with the occurrence of tumors in these patients. The study group included 34 patients (9 men (25.7%) and 25 women (74.3%)). No clear relationship between the levels of IGF-1 or GH and tumor development could be demonstrated, but certain risk factors, such as diabetes mellitus (DM) and obesity, were more frequent in patients with tumors. In total, 34 benign tumoral proliferations were identified, the most common being multinodular goiter. Malignant tumors were present only in women (14.70%) and the most frequent type was thyroid carcinoma. DM and obesity might be associated with tumoral proliferation in patients with acromegaly, and findings also present in the general population. In our study we did not find a direct link between acromegaly and tumoral proliferations.

摘要

肢端肥大症是一种罕见的疾病,与生长激素(GHs)水平升高有关,生长激素会刺激胰岛素样生长因子-1(IGF-1)的产生。GH 和 IGF-1 的过度分泌会激活通路,如 Janus 激酶 2/信号转导和转录激活因子 5(JAK2/STAT5)和丝裂原活化蛋白激酶(MAPK),这些通路与肿瘤的发生有关。鉴于该主题存在争议,我们决定研究我们的肢端肥大症患者队列中良性和恶性肿瘤的患病率。此外,我们旨在确定与这些患者肿瘤发生相关的危险因素或实验室参数。研究组包括 34 名患者(9 名男性(25.7%)和 25 名女性(74.3%))。虽然未能证明 IGF-1 或 GH 水平与肿瘤发展之间存在明确的关系,但某些危险因素,如糖尿病(DM)和肥胖症,在患有肿瘤的患者中更为常见。总共发现了 34 例良性肿瘤性增殖,最常见的是多结节性甲状腺肿。恶性肿瘤仅见于女性(14.70%),最常见的类型是甲状腺癌。DM 和肥胖症可能与肢端肥大症患者的肿瘤增殖有关,这在普通人群中也有发现。在我们的研究中,我们没有发现肢端肥大症与肿瘤增殖之间存在直接联系。