评估垂体肿瘤体积作为肢端肥大症的预后因素:两个中心的横断面研究。

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Mauricio Alvarez, Angel Donato, Juliana Rincon, Oswaldo Rincon, Natalia Lancheros, Pedro Mancera, Isaac Guzman
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引用次数: 0

摘要

背景:肢端肥大症是一种垂体神经内分泌肿瘤(PitNET),生长激素(GH)分泌过多,导致多系统并发症。先前的研究已经确定了手术后疾病持续性和对药物治疗不良反应的预测因素,包括肿瘤大小、腺瘤的垂直和水平延伸、t2加权磁共振成像的高强度、肉芽密度、术前和术后GH和胰岛素样生长因子1 (IGF-1)水平。目的:评价PitNET体积作为肢端肥大症患者的辅助预后因素。方法:这是一项回顾性描述性研究,具有分析成分,评估gh生成PitNETs的体积分析、手术前后IGF-1水平、随访期间的疾病控制以及在两个中心治疗的患者队列中疾病控制所需的治疗线之间的相关性:中央军事医院内分泌科和哥伦比亚波哥大的Centros msamicos Colsanitas。结果:共纳入77例肢端肥大症患者(男性42例,女性35例)。确诊时平均年龄42岁(SD: 12),平均病程9.9年(SD: 7.2)。垂体肿瘤平均体积为4358 mm³(SD: 6291,四分位数间距[IQR]: 13602)。控制性肢端肥大症患者的平均PitNET体积为3202 mm³(SD: 4845, 95%CI: 621-5784),而非控制性肢端肥大症患者的平均PitNET体积为5513 mm³(SD: 7447, 95%CI: 1545-9482) (P = 0.15)。PitNET容积超过3697 mm³与需要三线或四线治疗的可能性较高相关(50% vs 36%;P = 0.03)。结论:PitNET体积与肢端肥大症的高线治疗需求相关,但与长期疾病控制或术前或术后IGF-1水平无关。然而,观察到肿瘤体积与未来疾病控制呈负相关的趋势。虽然大腺瘤的分类仍然至关重要,但在大腺瘤患者中,体积超过3697 mm³的患者预后较差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of pituitary tumor volume as a prognostic factor in acromegaly: A cross-sectional study in two centers.

Background: Acromegaly is caused by a pituitary neuroendocrine tumor (PitNET) with excessive production of growth hormone (GH), leading to multisystem complications. Previous studies have identified predictors of disease persistence following surgery and poor response to medical treatment, including tumor size, vertical and horizontal extensions of the adenoma, hyperintensity in T2-weighted magnetic resonance imaging, granulation density, and pre- and postoperative GH and insulin-like growth factor 1 (IGF-1) levels.

Aim: To evaluate PitNET volume as a complementary prognostic factor in patients with acromegaly.

Methods: This is a retrospective descriptive study with an analytical component evaluating the correlation between the volumetric analysis of GH-producing PitNETs, IGF-1 levels before and after surgery, disease control during follow-up, and the line of therapy required for disease control in a cohort of patients treated at two centers: Endocrinology Department of the Central Military Hospital and Centros Médicos Colsanitas, Bogotá, Colombia.

Results: A total of 77 patients with acromegaly (42 men, 35 women) were included in this study. The mean age at diagnosis was 42 years (SD: 12), with a mean disease duration of 9.9 years (SD: 7.2). The mean pituitary tumor volume was 4358 mm³ (SD: 6291, interquartile range [IQR]: 13602). Patients with controlled acromegaly had a mean PitNET volume of 3202 mm³ (SD: 4845, 95%CI: 621-5784) compared to 5513 mm³ (SD: 7447, 95%CI: 1545-9482) in the uncontrolled group (P = 0.15). A PitNET volume exceeding 3697 mm³ was associated with a higher likelihood of requiring third or fourth-line therapy (50% vs 36%; P = 0.03).

Conclusion: PitNET volume was associated with the need for higher-line therapy to manage acromegaly but did not correlate with long-term disease control or with pre- or postsurgical IGF-1 levels. Nevertheless, a trend towards an inverse relationship between tumor volume and future disease control was observed. While macroadenoma classification remains crucial, among patients with macroadenomas, those with a volume exceeding 3697 mm³ could have worse prognosis.

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来源期刊
World journal of radiology
World journal of radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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