■在患有颅内生殖细胞肿瘤(iGCT)的个体中,延迟诊断对肿瘤相关预后的影响似乎很小。然而,其对神经内分泌功能的影响尚不清楚.我们旨在评估延迟诊断对鞍上GCT患者神经内分泌功能的影响。
■我们对459例鞍上GCT患者进行了一项回顾性队列研究,并根据疾病持续时间将其分为两组:延迟诊断(>6个月)和非延迟诊断(≤6个月)。我们比较了内分泌症状,神经内分泌功能障碍及其分级(根据严重程度分为0-3级),和神经内分泌功能障碍的恢复。
■延迟诊断的患者表现出更高的闭经发生率,生长缓慢,疲劳,和多尿/多饮。神经内分泌功能障碍,包括中枢肾上腺功能不全(CAI),中枢甲状腺功能减退症(CHT),精氨酸加压素缺乏症(AVP-D),生长激素缺乏,性腺功能减退,和高催乳素血症,在诊断时延迟诊断组中更为明显,治疗结束,和最后的后续行动。此外,延迟诊断的个体在诊断时表现出更高的神经内分泌功能障碍等级(OR=3.005,95%CI1.929-4.845,p<0.001),肿瘤治疗结束(OR=4.802,95%CI2.878-8.004,p<0.001),校正混杂因素后的最后一次随访(OR=2.335,95%CI1.307-4.170,p=0.005)。最后,复苏较少,特别是在CAI中,CHT,和AVP-D,在治疗后延迟诊断的组中观察到。
■在患有鞍上GCT的个体中,延迟诊断与增加有关,更严重,神经内分泌功能障碍恢复较少,强调早期诊断和治疗以减少神经内分泌功能障碍的重要性。
UNASSIGNED: The impact of delayed diagnosis on tumor-related prognosis appears to be minimal in individuals with intracranial germ cell tumors (iGCTs). However, its effect on neuroendocrine functions remains unclear. We aimed to assess the effects of delayed diagnosis on neuroendocrine function in individuals with suprasellar GCTs.
UNASSIGNED: We conducted a retrospective cohort study of 459 individuals with suprasellar GCTs and categorized them into two groups based on disease duration: delayed diagnosis (> 6 months) and non-delayed diagnosis (≤ 6 months). We compared endocrinological symptoms, neuroendocrine dysfunction and its grading (categorized into 0-3 grades based on severity), and recovery from neuroendocrine dysfunction in both groups.
UNASSIGNED: Patients with delayed diagnosis exhibited higher incidences of amenorrhea, slow growth, fatigue, and polyuria/polydipsia. Neuroendocrine dysfunction, including central adrenal insufficiency (CAI), central hypothyroidism (CHT), arginine vasopressin deficiency (AVP-D), growth hormone deficiency, hypogonadism, and hyperprolactinemia, was more pronounced in the delayed diagnosis group at diagnosis, the end of treatment, and the last follow-up. Furthermore, individuals with delayed diagnosis showed higher grades of neuroendocrine dysfunction at diagnosis (OR=3.005, 95% CI 1.929-4.845, p<0.001), end of oncologic treatment (OR=4.802, 95% CI 2.878-8.004, p<0.001), and last follow-up(OR=2.335, 95% CI 1.307-4.170, p=0.005) after adjusting for confounders. Finally, less recovery, particularly in CAI, CHT, and AVP-D, was seen among the group with delayed diagnosis after treatment.
UNASSIGNED: Among individuals with suprasellar GCTs, delayed diagnosis is associated with increased, more severe, and less recovered neuroendocrine dysfunction, emphasizing the importance of early diagnosis and treatment to reduce neuroendocrine dysfunction.