PDF(Pubmed)
Abstract：
BACKGROUND: The optimal therapeutic approach for cystic prolactinomas remains unclear. This study aimed to evaluate the remission rates of prolactinoma patients after surgical treatment and the risk factors affecting postoperative remission in cystic prolactinoma patients.
METHODS: The clinical data were retrospectively compiled from 141 patients with prolactinomas (including 41 cases of cystic prolactinomas, 21 cases of solid microprolactinomas and 79 cases of solid macroprolactinomas) who underwent transsphenoidal surgery (TSS) between April 2013 and October 2021 at the First Affiliated Hospital of Sun Yat-sen University.
RESULTS: Early postoperative remission was achieved in 65.83% (n = 27/41) of cystic prolactinomas, 80.95% (n = 17/21) of solid microprolactinomas and 40.51% (n = 32/79) of solid macroprolactinomas. The mean length of follow up in all patients was 43.95 ± 2.33 months (range: 6-105 months). The follow-up remission rates were 58.54%, 71.43% and 44.30% in cystic, solid micro- and solid macroprolactinomas, respectively. For cystic prolactinomas, the early postoperative remission rates in the patients with preoperative dopamine agonists (DA) treatment were significantly higher than those without preoperative DA treatment (p = 0.033), but the difference in the follow-up remission rates between these two groups was not significant (p = 0.209). Multivariate stepwise logistic regression analysis indicated that tumor size and preoperative prolactin (PRL) levels < 200 ng/ml were independent predictors for early postoperative remission in cystic prolactinomas.
CONCLUSIONS: For cystic prolactinomas, tumor size and preoperative PRL levels were independent predictors of early postoperative remission. Preoperative DA therapy combined with TSS may be more beneficial to cystic prolactinoma patients.
METHODS: The clinical data were retrospectively compiled from 141 patients with prolactinomas (including 41 cases of cystic prolactinomas, 21 cases of solid microprolactinomas and 79 cases of solid macroprolactinomas) who underwent transsphenoidal surgery (TSS) between April 2013 and October 2021 at the First Affiliated Hospital of Sun Yat-sen University.
RESULTS: Early postoperative remission was achieved in 65.83% (n = 27/41) of cystic prolactinomas, 80.95% (n = 17/21) of solid microprolactinomas and 40.51% (n = 32/79) of solid macroprolactinomas. The mean length of follow up in all patients was 43.95 ± 2.33 months (range: 6-105 months). The follow-up remission rates were 58.54%, 71.43% and 44.30% in cystic, solid micro- and solid macroprolactinomas, respectively. For cystic prolactinomas, the early postoperative remission rates in the patients with preoperative dopamine agonists (DA) treatment were significantly higher than those without preoperative DA treatment (p = 0.033), but the difference in the follow-up remission rates between these two groups was not significant (p = 0.209). Multivariate stepwise logistic regression analysis indicated that tumor size and preoperative prolactin (PRL) levels < 200 ng/ml were independent predictors for early postoperative remission in cystic prolactinomas.
CONCLUSIONS: For cystic prolactinomas, tumor size and preoperative PRL levels were independent predictors of early postoperative remission. Preoperative DA therapy combined with TSS may be more beneficial to cystic prolactinoma patients.
摘要：
背景：囊性泌乳素腺瘤的最佳治疗方法尚不清楚。本研究旨在评估泌乳素腺瘤患者手术治疗后的缓解率及影响其术后缓解的危险因素。
方法：回顾性收集141例泌乳素腺瘤患者的临床资料（包括41例囊性泌乳素腺瘤，2013年4月至2021年10月在中山大学附属第一医院接受经蝶窦手术（TSS）治疗的实性微泌乳素瘤21例，实性大泌乳素瘤79例）。
结果：65.83%（n=27/41）的囊性泌乳素腺瘤术后早期缓解，80.95％（n=17/21）的固体微泌乳素瘤和40.51％（n=32/79）的固体大泌乳素瘤。所有患者的平均随访时间为43.95±2.33个月（范围：6-105个月）。随访缓解率为58.54%,71.43%和44.30%在囊性，固体微-和固体大泌乳素瘤，分别。对于囊性泌乳素瘤，术前接受多巴胺激动剂(DA)治疗的患者术后早期缓解率明显高于未接受DA治疗的患者(p=0.033),但两组间随访缓解率差异不显著(p=0.209).多因素逐步logistic回归分析表明，肿瘤大小和术前泌乳素（PRL）水平<200ng/ml是囊性泌乳素瘤术后早期缓解的独立预测因素。
结论：对于囊性泌乳素瘤，肿瘤大小和术前PRL水平是术后早期缓解的独立预测因素.术前DA联合TSS治疗可能更有利于囊性泌乳素腺瘤患者。
方法：回顾性收集141例泌乳素腺瘤患者的临床资料（包括41例囊性泌乳素腺瘤，2013年4月至2021年10月在中山大学附属第一医院接受经蝶窦手术（TSS）治疗的实性微泌乳素瘤21例，实性大泌乳素瘤79例）。
结果：65.83%（n=27/41）的囊性泌乳素腺瘤术后早期缓解，80.95％（n=17/21）的固体微泌乳素瘤和40.51％（n=32/79）的固体大泌乳素瘤。所有患者的平均随访时间为43.95±2.33个月（范围：6-105个月）。随访缓解率为58.54%,71.43%和44.30%在囊性，固体微-和固体大泌乳素瘤，分别。对于囊性泌乳素瘤，术前接受多巴胺激动剂(DA)治疗的患者术后早期缓解率明显高于未接受DA治疗的患者(p=0.033),但两组间随访缓解率差异不显著(p=0.209).多因素逐步logistic回归分析表明，肿瘤大小和术前泌乳素（PRL）水平<200ng/ml是囊性泌乳素瘤术后早期缓解的独立预测因素。
结论：对于囊性泌乳素瘤，肿瘤大小和术前PRL水平是术后早期缓解的独立预测因素.术前DA联合TSS治疗可能更有利于囊性泌乳素腺瘤患者。
