Acromegaly: biochemical assessment of cure after long term follow-up of transsphenoidal selective adenomectomy.
Acromegaly: biochemical assessment of cure after long term follow-up of transsphenoidal selective adenomectomy.
复制标题
肢端肥大症：经蝶选择性腺瘤切除术长期随访后治愈的生化评估。
DOI：
10.1210/jcem-61-6-1185
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发表时间：
1985
期刊：
影响因子：
--
通讯作者：
J. Hardy
中科院分区：
文献类型：
--
作者：
O. Serri;M. Somma;Ronald Comtois;E. Rasio;Hugues Beauregard;N. Jilwan;J. Hardy
This study reports the clinical and biological follow-up 5-11 yr after transsphenoidal selective adenomectomy in 25 patients with acromegaly. Eight patients had microadenomas, and 17 had macroadenomas. Initial normalization of plasma GH levels (basal values, less than 5 ng/ml; glucose-suppressed concentrations, less than 2.5 ng/ml) was achieved in all 8 patients with microadenomas and in 13 patients with macroadenomas. Of these, 3 patients with normal GH levels and dynamics had relapse of GH hypersecretion after intervals between 1-6 yr after microadenoma removal. Recurrence of pituitary adenoma was documented by surgery in 1 patient and by computed tomographic scanning in 2 others. Normal basal and glucose-suppressed plasma GH concentrations were maintained 7.4 +/- 0.5 (+/- SEM) yr after adenomectomy in 7 patients with microadenomas and in all 10 patients with macroadenomas. Thus, 88% of the patients with microadenomas and 59% of the patients with macroadenomas were cured, and the overall cure rate was 68%. We conclude that recurrence of acromegaly after successful surgery may occur late after adenoma removal and that it cannot be predicted by normal postoperative GH levels and dynamics. However, in view of the overall cure rate, transsphenoidal adenomectomy remains a most valuable treatment for acromegaly.
