Shutova A S, Dzeranova L K, Vorotnikova S Yu, Kutin M A, Pigarova E A
Endocrinology Research Centre.
N.N. Burdenko National Medical Research Center of Neurosurgery.
Probl Endokrinol (Mosk). 2023 Jun 30;69(3):44-50. doi: 10.14341/probl13222.
Prolactinomas are the most common secreting adenomas of the pituitary. In 20% of cases resistance to dopamine-agonists treatment is observed. Medical therapy resistance causes progression of pathological symptoms of hyperprolactinemia and negative topographic and anatomical changes of prolactinoma. The causes of ineffectiveness of dopamine agonists therapy are not fully understood as well as approaches to managing patients require clarification. Current concepts of resistance are based on the data obtained as a result of surgery or after a period of long-term ineffective therapy. Thus, it is very important to find methods of assessing the sensitivity of prolactin-secreting adenomas to drug therapy before surgical treatment. Genetic and immunohistochemical studies find special place among these methods, making it possible to predict adenoma's response to drug therapy at early diagnostic stage. Obtained results will allow us to form personalized algorithm for managing patients.
泌乳素瘤是垂体最常见的分泌性腺瘤。在20%的病例中，可观察到对多巴胺激动剂治疗的耐药性。药物治疗耐药会导致高泌乳素血症病理症状的进展以及泌乳素瘤的负面地形学和解剖学变化。多巴胺激动剂治疗无效的原因尚未完全明确，并且管理患者的方法也需要阐明。目前关于耐药性的概念是基于手术结果或经过一段时间的长期无效治疗后获得的数据。因此，在手术治疗前找到评估泌乳素分泌性腺瘤对药物治疗敏感性的方法非常重要。基因和免疫组化研究在这些方法中占有特殊地位，使得在早期诊断阶段就能够预测腺瘤对药物治疗的反应。获得的结果将使我们能够形成个性化的患者管理算法。
