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菲律宾总医院成年催乳素瘤患者的流行病学概况及临床结局

Epidemiologic Profile and Clinical Outcomes of Adult Patients with Prolactinoma at the Philippine General Hospital.

作者信息

Pilit Ma Belen B, Añonuevo-Cruz Ma Cecille, Jimeno Cecilia A

机构信息

Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Philippine General Hospital, University of the Philippines Manila.

Department of Pharmacology and Toxicology, College of Medicine, University of the Philippines Manila.

出版信息

Acta Med Philipp. 2025 Jun 30;59(8):27-34. doi: 10.47895/amp.vi0.10588. eCollection 2025.

Abstract

BACKGROUND AND OBJECTIVE

Prolactinoma is the most common functioning tumor of the pituitary gland. While its clinical course and outcomes among different populations have been vastly described in the past, data of prolactinoma among Filipinos has not been explored. This paper aims to describe the clinical profile and outcome of prolactinoma among adult Filipino patients.

METHODS

We conducted a retrospective cohort study including 41 patients with prolactinoma seen at the Philippine General Hospital. The clinical profile, cranial imaging features, treatment modalities given, and their outcomes over a mean follow up of 16 months were evaluated.

RESULTS

The mean age at diagnosis was 36.76 ±13.99 years. Majority of our cohort were females. Macroprolactinoma were found in 75.61% and giant prolactinoma in 9.76%. The remaining 12.2% were mixed GH and PRL secreting tumors. Most common symptoms at presentation were blurring of vision, headache, and amenorrhea. Median PRL levels was 353 (200-470) ng/ml. Medical therapy with Bromocriptine was the primary treatment modality used in 78% of patients. We found no significant difference between patients who underwent surgical and medical primary treatment modalities in terms of outcomes. At the end of follow up, 82.6 % of patients achieved at least more than 50% reduction in their prolactin levels.

CONCLUSION

Overall, our study showed that adult Filipino patients with prolactinoma have a larger tumor size at diagnosis and a lower rate of improvement of gonadal function after treatment. There were no statistically significant differences in clinical and biochemical outcomes between the treatment modalities used.

摘要

背景与目的

泌乳素瘤是最常见的垂体功能性肿瘤。尽管过去已大量描述了其在不同人群中的临床病程和结局,但尚未探究菲律宾人群中泌乳素瘤的数据。本文旨在描述成年菲律宾患者中泌乳素瘤的临床特征和结局。

方法

我们进行了一项回顾性队列研究,纳入了在菲律宾总医院就诊的41例泌乳素瘤患者。评估了其临床特征、头颅影像学特征、给予的治疗方式及其在平均16个月随访期内的结局。

结果

诊断时的平均年龄为36.76±13.99岁。我们队列中的大多数为女性。75.61%为大泌乳素瘤,9.76%为巨大泌乳素瘤。其余12.2%为生长激素和泌乳素混合分泌性肿瘤。就诊时最常见的症状为视力模糊、头痛和闭经。泌乳素水平中位数为353(200 - 470)ng/ml。78%的患者主要采用溴隐亭进行药物治疗。我们发现接受手术和药物初始治疗方式的患者在结局方面无显著差异。随访结束时,82.6%的患者泌乳素水平至少降低了50%以上。

结论

总体而言,我们的研究表明成年菲律宾泌乳素瘤患者诊断时肿瘤体积较大,治疗后性腺功能改善率较低。所用治疗方式在临床和生化结局方面无统计学显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faa2/12314436/1586925bf374/AMP-59-8-10588-g001.jpg

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