Pathological study of thyrotropin-secreting pituitary adenoma: plurihormonality and medical treatment
Pathological study of thyrotropin-secreting pituitary adenoma: plurihormonality and medical treatment
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DOI：
10.1007/s00401-004-0863-x
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发表时间：
2004-08-01
影响因子：
12.7
通讯作者：
Osamura, YR
中科院分区：
文献类型：
--
作者：
Teramoto, A;Sanno, N;Osamura, YR
促甲状腺激素（TSH）分泌腺瘤是罕见的，因为大多数腺瘤是大的，侵入性和难以治愈的手术，只有许多需要额外的药物治疗。许多促甲状腺激素分泌腺瘤共同分泌生长激素（GH）和/或催乳素（PRL）。我们评估了20例手术治疗的TSH分泌腺瘤患者的病理与多巴胺受体激动剂溴隐亭和生长抑素类似物奥曲肽的疗效之间的关系。4名男性和16名女性的年龄从23岁到62岁不等; 3名有临床上明显的肢端肥大症; 2名表现为溢乳闭经。内分泌，血清GH和/或IGF-1升高，观察到6例患者和血清PRL升高，观察到8。免疫组化显示，20例腺瘤中有16例GH和/或PRL阳性（GH阳性，n=13; PRL阳性，n=9）。垂体特异性转录因子Pit-1在所有腺瘤细胞的细胞核中被证明。奥曲肽试验显示抑制血清TSH（
Thyrotropin (TSH)-secreting adenomas are rare and, as most adenomas are large, invasive and difficult to cure by surgery only, many require additional medical treatment. Many TSH-secreting adenomas cosecrete growth hormone (GH) and/or prolactin (PRL). We evaluated the relationship between pathology and the effect of dopamine agonist bromocriptine and somatostatin analogue octreotide in 20 operated patients with TSH-secreting adenomas. The four men and 16 women ranged in age from 23 to 62 years; three had clinically overt acromegaly; two manifested galactorrhea-amenorrhea. Endocrinologically, elevated serum GH, and/or IGF-1 were observed in six patients and elevated serum PRL was observed in eight. Immunohistochemically, 16 of the 20 adenomas were positive for GH and/or PRL (GH-positive, n=13; PRL-positive, n=9). Pituitary-specific transcription factor Pit-1 was demonstrated in the nuclei of all adenoma cells. Octreotide tests showed suppression of serum TSH (