Silent corticotroph adenomas have unique recurrence characteristics compared with other nonfunctioning pituitary adenomas
Silent corticotroph adenomas have unique recurrence characteristics compared with other nonfunctioning pituitary adenomas
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DOI：
10.1111/j.1365-2265.2009.03673.x
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发表时间：
2010-05-01
影响因子：
3.2
通讯作者：
Kim, Seong Yeon
中科院分区：
文献类型：
--
作者：
Cho, Hwa Young;Cho, Sun Wook;Kim, Seong Yeon
无症状促肾上腺皮质激素腺瘤（SCA）在无功能垂体腺瘤（NFPAs）中并不少见;然而，SCA的临床意义是否与无ACTH免疫反应性的NFPAs（non-SCA）不同尚不清楚。我们的目标是比较SCAs和非SCAs.Design/patientsWe患者的临床特征和自然史，我们回顾了1990年1月至2007年10月在首尔国立大学医院接受经蝶手术治疗NFPAs的所有患者的病历。SCA和non-SCA patients.ResultsIn的术后复发率和复发特点不同，共28例与SCA和134例与non-SCA进行了分析。诊断时的平均年龄为44岁SCA组（范围，13-67岁）和50岁非SCA组（18-79岁）（P = 0，中心点026），各随访期为5个中心点2（范围，1个中心点0-16个中心点0年）和4个中心点2年（0个中心点5-16个中心点1年）（P = 0个中心点255）。SCA和非SCA的总复发率分别为25个中心点0%和26个中心点9%（P = 0，中心点839）。两次以上复发（P = 0，中点0.01）和5年以上复发（P = 0，中点0.40）与SCA相关。SCA的多次复发局限于年轻patients.ConclusionThe总体复发率是相似的SCA和非SCA之间。然而，患有SCA的年轻患者有更高的多次和晚期复发频率，表现出更具侵略性的肿瘤行为。因此，我们建议SCA患者，特别是在年轻时诊断的患者，需要仔细的长期监测。
P>ObjectiveThe prevalence of silent corticotroph adenomas (SCAs) is not rare among nonfunctioning pituitary adenomas (NFPAs); however, it is unknown whether the clinical significance of SCAs differs from that of NFPAs without ACTH immunoreactivity (non-SCAs). Our goal was to compare the clinical characteristics and natural history between patients with SCAs and non-SCAs.Design/patientsWe reviewed the medical records of all patients who underwent transsphenoidal surgery for NFPAs from January 1990 to October 2007 at the Seoul National University Hospital.MeasurementsWe analysed whether clinical manifestations at diagnosis, postoperative recurrence rate and recurrence characteristics differed between SCA and non-SCA patients.ResultsIn total, 28 patients with SCAs and 134 patients with non-SCAs were analysed. The mean age at the time of diagnosis was 44 years (range, 13-67 years) in the SCA group and 50 years (18-79 years) in the non-SCA group (P = 0 center dot 026), with respective follow-up periods of 5 center dot 2 (range, 1 center dot 0-16 center dot 0 years) and 4 center dot 2 years (0 center dot 5-16 center dot 1 years) (P = 0 center dot 255). Overall recurrence rates of SCAs and non-SCAs were 25 center dot 0% and 26 center dot 9% respectively (P = 0 center dot 839). More than two recurrences (P = 0 center dot 001) and recurrence after more than 5 years (P = 0 center dot 040) were associated with SCAs. Multiple recurrences of SCAs were confined to younger patients.ConclusionThe overall recurrence rate was similar between SCAs and non-SCAs. However, young patients with SCAs had a higher frequency of multiple and late recurrences, which showed more aggressive tumour behaviour. Therefore, we suggest that patients with SCAs, especially patients diagnosed at a young age, require careful long-term monitoring.