PDF(Pubmed)
Abstract：
UNASSIGNED: Usually, prolactinomas are treated with dopamine agonists (DA). Surgery is considered an option when the patient cannot bear or does not respond positively to DA therapy.
UNASSIGNED: This study aims to determine the early and late outcomes of surgery, with particular emphasis on developing prognostic factors for surgical treatment and analyzing risk factors affecting the recurrence of hyperprolactinemia and prolactinoma.
UNASSIGNED: This retrospective study was conducted at the Feofaniya Clinical Hospital of the State Administration of Affairs (Kyiv, Ukraine), evaluating 109 patients\' records from 2009 to 2019. The main patients\' inclusion criteria were: serum prolactin (PRL) level of more than 100 ng/ml, presence of pituitary adenoma (PA) on MRI, histologically approved PA by microscopy. According to the size of the prolactin-secreting PA (PSPAs) the selected 109 patients were divided into two groups: micro- (≤10 mm, n = 75) and macroadenoma group (10-40 mm, n = 34).
UNASSIGNED: 1 month after the operation, PRL levels decreased by 87% (p < 0.001), 12 months-by 93% (p < 0.001). After receiving surgery and DA therapy for 12 months 77.1% of patients achieved biochemical remission. Out of the total number of patients observed, 15.6% (n = 17) had a Knosp score greater than 3. Additionally, in the macroadenoma group, the percentage of patients with a Knosp score greater than 3 was 41,2%, which was significantly higher as compared to the microadenoma group (4%, p < 0.001). In patients with microadenomas a weak reverse correlation between patients\' age (r = -0.258, p < 0.026) and positive with tumor size (r = 0.251, p < 0.030) was revealed. In the macroadenoma group significant association was found only between preoperative serum PRL level and tumor size (r = 0.412, p < 0.016). The preoperative PRL can be used as a diagnostic marker for lack of early biochemical remission in patients with PSPAs with diagnostic accuracy 66.9%.
UNASSIGNED: This study found that primary transsphenoidal surgery is an effective treatment in reaching PRL level control in patients with both micro- and macroprolactinomas. The correct and thorough selection of candidates for surgery is crucial to achieve postoperative serum PRL normalization in the vast majority of patients.
UNASSIGNED: This study aims to determine the early and late outcomes of surgery, with particular emphasis on developing prognostic factors for surgical treatment and analyzing risk factors affecting the recurrence of hyperprolactinemia and prolactinoma.
UNASSIGNED: This retrospective study was conducted at the Feofaniya Clinical Hospital of the State Administration of Affairs (Kyiv, Ukraine), evaluating 109 patients\' records from 2009 to 2019. The main patients\' inclusion criteria were: serum prolactin (PRL) level of more than 100 ng/ml, presence of pituitary adenoma (PA) on MRI, histologically approved PA by microscopy. According to the size of the prolactin-secreting PA (PSPAs) the selected 109 patients were divided into two groups: micro- (≤10 mm, n = 75) and macroadenoma group (10-40 mm, n = 34).
UNASSIGNED: 1 month after the operation, PRL levels decreased by 87% (p < 0.001), 12 months-by 93% (p < 0.001). After receiving surgery and DA therapy for 12 months 77.1% of patients achieved biochemical remission. Out of the total number of patients observed, 15.6% (n = 17) had a Knosp score greater than 3. Additionally, in the macroadenoma group, the percentage of patients with a Knosp score greater than 3 was 41,2%, which was significantly higher as compared to the microadenoma group (4%, p < 0.001). In patients with microadenomas a weak reverse correlation between patients\' age (r = -0.258, p < 0.026) and positive with tumor size (r = 0.251, p < 0.030) was revealed. In the macroadenoma group significant association was found only between preoperative serum PRL level and tumor size (r = 0.412, p < 0.016). The preoperative PRL can be used as a diagnostic marker for lack of early biochemical remission in patients with PSPAs with diagnostic accuracy 66.9%.
UNASSIGNED: This study found that primary transsphenoidal surgery is an effective treatment in reaching PRL level control in patients with both micro- and macroprolactinomas. The correct and thorough selection of candidates for surgery is crucial to achieve postoperative serum PRL normalization in the vast majority of patients.
摘要：
■通常，用多巴胺激动剂（DA）治疗泌乳素瘤。当患者不能承受DA治疗或对DA治疗没有积极反应时，手术被认为是一种选择。
■这项研究旨在确定手术的早期和晚期结果，重点探讨手术治疗的预后因素，分析影响高泌乳素血症和泌乳素瘤复发的危险因素。
■这项回顾性研究是在国家事务管理局Feofaniya临床医院进行的（基辅，乌克兰),评估2009年至2019年109例患者的记录。患者的主要纳入标准为：血清催乳素（PRL）水平超过100ng/ml，MRI上存在垂体腺瘤（PA），通过显微镜组织学批准的PA。根据分泌催乳素的PA（PSPAs）的大小，将109例患者分为两组：微（≤10mm，n=75）和大型腺瘤组（10-40毫米，n=34）。
■手术后1个月，PRL水平下降了87%(p<0.001)，12个月-93％（p<0.001）。在接受手术和DA治疗12个月后，77.1％的患者实现了生化缓解。在观察到的患者总数中，15.6%(n=17)的Knosp评分大于3。此外,在大型腺瘤组中，Knosp评分大于3的患者百分比为41,2%,显着高于微腺瘤组（4％，p<0.001)。在微腺瘤患者中，患者年龄（r=-0.258，p<0.026）与肿瘤大小呈阳性（r=0.251，p<0.030）之间的反向相关性较弱。在大型腺瘤组中，仅在术前血清PRL水平与肿瘤大小之间发现了显着关联（r=0.412，p<0.016）。术前PRL可作为PSPAs患者缺乏早期生化缓解的诊断指标，诊断准确率为66.9%。
■这项研究发现，原发性经蝶窦手术是一种有效的治疗方法，可在微泌乳素和大型泌乳素瘤患者中达到PRL水平控制。正确和彻底选择手术候选人对于在绝大多数患者中实现术后血清PRL正常化至关重要。
■这项研究旨在确定手术的早期和晚期结果，重点探讨手术治疗的预后因素，分析影响高泌乳素血症和泌乳素瘤复发的危险因素。
■这项回顾性研究是在国家事务管理局Feofaniya临床医院进行的（基辅，乌克兰),评估2009年至2019年109例患者的记录。患者的主要纳入标准为：血清催乳素（PRL）水平超过100ng/ml，MRI上存在垂体腺瘤（PA），通过显微镜组织学批准的PA。根据分泌催乳素的PA（PSPAs）的大小，将109例患者分为两组：微（≤10mm，n=75）和大型腺瘤组（10-40毫米，n=34）。
■手术后1个月，PRL水平下降了87%(p<0.001)，12个月-93％（p<0.001）。在接受手术和DA治疗12个月后，77.1％的患者实现了生化缓解。在观察到的患者总数中，15.6%(n=17)的Knosp评分大于3。此外,在大型腺瘤组中，Knosp评分大于3的患者百分比为41,2%,显着高于微腺瘤组（4％，p<0.001)。在微腺瘤患者中，患者年龄（r=-0.258，p<0.026）与肿瘤大小呈阳性（r=0.251，p<0.030）之间的反向相关性较弱。在大型腺瘤组中，仅在术前血清PRL水平与肿瘤大小之间发现了显着关联（r=0.412，p<0.016）。术前PRL可作为PSPAs患者缺乏早期生化缓解的诊断指标，诊断准确率为66.9%。
■这项研究发现，原发性经蝶窦手术是一种有效的治疗方法，可在微泌乳素和大型泌乳素瘤患者中达到PRL水平控制。正确和彻底选择手术候选人对于在绝大多数患者中实现术后血清PRL正常化至关重要。
