无功能垂体腺瘤的临床管理策略  

Clinical management strategies for non-functional pituitary adenomas

作　　者：徐茜 韩香 赵静 鞠海兵 Xu Qian;Han Xiang;Zhao Jing;Ju Hai-Bing(Department of Endocrinology,920th Hospital of Joint Logistics Support Force of Chinese PLA,Kunming,Yunnan 650032,China)

机构地区：[1]解放军联勤保障部队第920医院内分泌科,云南昆明650032

出　　处：《解放军医学杂志》2024年第11期1259-1265,共7页Medical Journal of Chinese People's Liberation Army

基　　金：云南省兴滇英才医疗卫生人才项目(XDYC-YLWS-2023-0098)。

摘　　要：无功能垂体腺瘤(NFPAs)是较常见的颅内鞍区肿瘤,近年来随着计算机断层扫描(CT)和磁共振成像(MRI)在临床的广泛应用,其诊断率明显增高。NFPAs无生化上的激素分泌增多,故可无明显的临床表现,而随着肿瘤的增大可表现为肿块压迫症状,如头痛、视力受损及相关垂体靶腺功能减退症状,甚至出现危及生命的垂体卒中。NFPAs患者垂体功能的评估和治疗方案的选择需要多学科团队的密切合作和科学管理。NFPAs发生发展的遗传和表观遗传机制尚未完全阐明,通过全基因组测序结合染色质结构分析等技术,可能开发出新的治疗策略。本文就NFPAs的流行病学、组织病理学、临床诊治及预后的研究进展进行系统阐述,以期为临床管理提供借鉴和指导。Non-functional pituitary adenomas(NFPAs)are relatively common intracranial sellar tumors.The diagnostic rate of NFPAs has significantly increased in recent years due to the widespread application of computed tomography(CT)and magnetic resonance imaging(MRI)in clinical practice.NFPAs do not exhibit increased biochemical hormone secretion,so they may not present with obvious clinical manifestations.However,as the tumor grows,it can cause mass effect symptoms,such as headache,visual impairment,and related pituitary target gland dysfunction,and even life-threatening pituitary stroke.The evaluation of pituitary function in patients with NFPAs and the selection of treatment plans require close collaboration and scientific management by a multidisciplinary team.The genetic and epigenetic mechanisms underlying the occurrence and development of NFPAs have not yet been fully elucidated.New treatment strategies may be developed through technologies such as whole-genome sequencing combined with chromatin structure analysis.This review systematically summarizes the research progress in epidemiology,histopathology,clinical diagnosis,treatment,and prognosis of NFPAs,aiming to provide reference and guidance for clinical management.

关 键 词：无功能垂体腺瘤 垂体功能 经鼻碟手术 放射治疗 多巴胺受体激动剂 

分 类 号：R736.4[医药卫生—肿瘤]