Pathak Preetam, Mishra Anupam, Mishra Subhash C
Nepalgunj Medical College, Kohalpur, Nepal.
Department of Otorhinolaryngology and Head and Neck Surgery King George's Medical University, Lucknow, India.
Indian J Otolaryngol Head Neck Surg. 2025 Jun;77(6):2283-2292. doi: 10.1007/s12070-025-05487-4. Epub 2025 Apr 24.
Objective: In an attempt to rationalize Hormone therapy (HT) in juvenile nasopharyngeal angiofibroma (JNA) this study intends to investigate the pituitary axis and clinical profile to further establish dominant hormonal-environment based upon secondary sexual characteristics along with other novel possibilities for HT. Design: Prospective observational study. Setting: Tertiary health care centre. Participants: Thirty-three patients were analysed in terms of age, secondary sexual characteristics (SSC), staging, preoperative serum-hormone profile and weight/ volume of excised tumour. Main outcome measures: Serum levels of prolactin, testosterone, oestrogens, progesterone, LH and secondary sexual characteristics. Results: Significant correlation was seen between LH/ testosterone/ estrogen on one hand while LH/ GH/ progesterone on other. LH/ testosterone correlated with age, tumour weight, & almost all SSC. Oestrogen correlated with age, & all SSC (except facial hair/ laryngeal prominence/ deepening of voice). Accordingly, 2 sets of SSC (clinical surrogate markers) defined estrogenic or androgenic predominance in JNA. Conclusions: The clinical surrogates may indirectly reflect corresponding receptor activity (rather than isolated hormone level) and provide a better rationale for selecting a particular HT.
The online version contains supplementary material available at 10.1007/s12070-025-05487-4.
目的:为使青少年鼻咽血管纤维瘤(JNA)的激素治疗(HT)更合理,本研究旨在调查垂体轴和临床特征,以基于第二性征进一步确定主要的激素环境以及HT的其他新可能性。设计:前瞻性观察研究。地点:三级医疗保健中心。参与者:对33例患者的年龄、第二性征(SSC)、分期、术前血清激素谱以及切除肿瘤的重量/体积进行了分析。主要观察指标:催乳素、睾酮、雌激素、孕酮、促黄体生成素(LH)的血清水平以及第二性征。结果:一方面,LH/睾酮/雌激素之间存在显著相关性,另一方面,LH/生长激素(GH)/孕酮之间也存在显著相关性。LH/睾酮与年龄、肿瘤重量以及几乎所有的第二性征相关。雌激素与年龄以及所有的第二性征(除面部毛发/喉结/声音变粗外)相关。因此,两组第二性征(临床替代标志物)可确定JNA中雌激素或雄激素的优势地位。结论:临床替代指标可能间接反映相应的受体活性(而非单一激素水平),并为选择特定的HT提供更好的理论依据。
在线版本包含可在10.1007/s12070 - 025 - 05487 - 4获取的补充材料。