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男性泌乳素瘤的治疗经验:一项单中心10年回顾性研究

Experience in the Treatment of Male Prolactinomas: A Single-Center, 10-Year Retrospective Study.

作者信息

Ke Xiaoan, Chen Xiaoxue, Wang Linjie, Duan Lian, Yang Hongbo, Yao Yong, Deng Kan, Pan Hui, Gong Fengying, Zhu Huijuan

机构信息

Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China,

Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China.

出版信息

Neuroendocrinology. 2024;114(12):1077-1089. doi: 10.1159/000541495. Epub 2024 Sep 27.

Abstract

INTRODUCTION

Male prolactinomas are uncommon and typically macroadenomas with difficult treatment and management. The purpose of this study was to summarize the treatment and management experiences of 254 male prolactinoma patients at a single center.

METHODS

This was a 10-year retrospective study conducted at a single center. A total of 254 male prolactinoma patients were included. Clinical data for all subjects were collected using an electronic medical record system.

RESULTS

A total of 254 male patients with prolactinoma were studied. Their median age at onset was 28.8 years, and median disease duration was 28.5 months. The median PRL levels were 582.0 ng/mL at diagnosis. Their median maximum tumor diameter was 23.0 mm, with macroadenoma accounting for the majority (76.7%). After treatment, the biochemical remission rate with monotherapy was 36.6%, but significantly increased to 60.6% with multidisciplinary treatment (p < 0.001). Knosp 0-2 patients had significantly higher rates of biochemical remission compared to Knosp 3-4 (all p < 0.05). In addition, the maximum diameter of adenoma (B = -0.110, p = 0.008) and cavernous sinus invasion (B = -1.741, p = 0.023) were negatively correlated with postoperative biochemical remission. The maximum diameter of the adenoma (B = - 0.131, p < 0.001) was a negative correlation factor, while treatment duration (B = 0.034, p = 0.002) was a positive correlation factor for biochemical response to medication.

CONCLUSION

Male prolactinoma has a low biochemical remission rate when treated alone, but multitherapy can improve it even more. Surgery may also be considered for male prolactinoma with a micro, and noninvasive tumor after a thorough evaluation.

INTRODUCTION

Male prolactinomas are uncommon and typically macroadenomas with difficult treatment and management. The purpose of this study was to summarize the treatment and management experiences of 254 male prolactinoma patients at a single center.

METHODS

This was a 10-year retrospective study conducted at a single center. A total of 254 male prolactinoma patients were included. Clinical data for all subjects were collected using an electronic medical record system.

RESULTS

A total of 254 male patients with prolactinoma were studied. Their median age at onset was 28.8 years, and median disease duration was 28.5 months. The median PRL levels were 582.0 ng/mL at diagnosis. Their median maximum tumor diameter was 23.0 mm, with macroadenoma accounting for the majority (76.7%). After treatment, the biochemical remission rate with monotherapy was 36.6%, but significantly increased to 60.6% with multidisciplinary treatment (p < 0.001). Knosp 0-2 patients had significantly higher rates of biochemical remission compared to Knosp 3-4 (all p < 0.05). In addition, the maximum diameter of adenoma (B = -0.110, p = 0.008) and cavernous sinus invasion (B = -1.741, p = 0.023) were negatively correlated with postoperative biochemical remission. The maximum diameter of the adenoma (B = - 0.131, p < 0.001) was a negative correlation factor, while treatment duration (B = 0.034, p = 0.002) was a positive correlation factor for biochemical response to medication.

CONCLUSION

Male prolactinoma has a low biochemical remission rate when treated alone, but multitherapy can improve it even more. Surgery may also be considered for male prolactinoma with a micro, and noninvasive tumor after a thorough evaluation.

摘要

引言

男性泌乳素瘤并不常见,通常为大腺瘤,治疗和管理较为困难。本研究的目的是总结单中心254例男性泌乳素瘤患者的治疗和管理经验。

方法

这是一项在单中心进行的为期10年的回顾性研究。共纳入254例男性泌乳素瘤患者。使用电子病历系统收集所有受试者的临床数据。

结果

共研究了254例男性泌乳素瘤患者。他们的发病年龄中位数为28.8岁,疾病持续时间中位数为28.5个月。诊断时泌乳素(PRL)水平中位数为582.0 ng/mL。他们的最大肿瘤直径中位数为23.0 mm,大腺瘤占大多数(76.7%)。治疗后,单药治疗的生化缓解率为36.6%,但多学科治疗显著提高至60.6%(p<0.001)。与Knosp 3-4级患者相比,Knosp 0-2级患者的生化缓解率显著更高(所有p<0.05)。此外,腺瘤最大直径(B=-0.110,p=0.008)和海绵窦侵犯(B=-1.741,p=0.023)与术后生化缓解呈负相关。腺瘤最大直径(B=-0.131,p<0.001)是负相关因素,而治疗持续时间(B=0.034,p=0.002)是药物生化反应的正相关因素。

结论

男性泌乳素瘤单独治疗时生化缓解率较低,但多学科治疗可进一步提高缓解率。对于经过全面评估的微腺瘤且无侵袭性的男性泌乳素瘤患者,也可考虑手术治疗。

引言

男性泌乳素瘤并不常见,通常为大腺瘤,治疗和管理较为困难。本研究的目的是总结单中心254例男性泌乳素瘤患者的治疗和管理经验。

方法

这是一项在单中心进行的为期10年的回顾性研究。共纳入254例男性泌乳素瘤患者。使用电子病历系统收集所有受试者的临床数据。

结果

共研究了254例男性泌乳素瘤患者。他们的发病年龄中位数为28.8岁,疾病持续时间中位数为28.5个月。诊断时泌乳素(PRL)水平中位数为582.0 ng/mL。他们的最大肿瘤直径中位数为23.0 mm,大腺瘤占大多数(76.7%)。治疗后,单药治疗的生化缓解率为36.6%,但多学科治疗显著提高至60.6%(p<0.001)。与Knosp 3-4级患者相比,Knosp 0-2级患者的生化缓解率显著更高(所有p<0.05)。此外,腺瘤最大直径(B=-0.110,p=0.008)和海绵窦侵犯(B=-1.741,p=0.023)与术后生化缓解呈负相关。腺瘤最大直径(B=-0.131,p<0.001)是负相关因素,而治疗持续时间(B=0.034,p=0.002)是药物生化反应的正相关因素。

结论

男性泌乳素瘤单独治疗时生化缓解率较低,但多学科治疗可进一步提高缓解率。对于经过全面评估的微腺瘤且无侵袭性的男性泌乳素瘤患者,也可考虑手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/656c/11817860/59becd58ea21/nen-2024-0114-0012-541495_F01.jpg

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