改进对无功能垂体腺瘤手术切除的放射学预测。

IF 5.4 2区 医学 Q1 Medicine Journal of Endocrinological Investigation Pub Date : 2024-11-05 DOI:10.1007/s40618-024-02479-z
Eduardo Giardini, Monique Alvares Barbosa, Nina Ventura, Paulo José da Mata Pereira, André Guasti, Paulo Niemeyer, Felipe Andreiuolo, Leila Chimelli, Leandro Kasuki, Mônica R Gadelha
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引用次数: 0

摘要

目的:无功能垂体腺瘤(NFPA)是生长在蝶窦区域的良性肿瘤。在保留邻近结构的前提下,建议首选手术切除病灶。我们的目的是建立一个放射学评分来预测NFPA全切手术的可行性:方法:纳入经蝶窦入路、术前和术后 3 个月接受蝶窦磁共振成像(MRI)检查的未经治疗的 NFPA 患者。收集了有关年龄、性别、肿瘤直径、鞍外扩展、术后治愈率以及激素和转录因子表达的数据。根据 Knosp 和 SIPAP 的分类提出了一个综合评分。根据肿瘤向蝶鞍上、蝶鞍下、蝶鞍前和蝶鞍后方向的延伸,我们提出了 3 个分类组:共有 164 名患者参与研究,其中 85 名(52%)为女性。46%的患者(75人)接受了全切除术。大多数肿瘤属于性腺营养型(59%),其次是皮质营养型(17%)和其他较少见的类型。最大肿瘤直径为 6.8 厘米[平均 3.8 厘米(± 1.1 厘米)]。在已确定的组别中,10 名患者被归入 I 组,其中 8 名(80%)患者接受了全切术;115 名患者被归入 II 组,其中 58 名(50%)患者接受了全切术;39 名患者被归入 III 组,其中 9 名(23%)患者接受了全切术(P 值 结论:新提出的评分有助于确定肿瘤的类型:新提出的评分有助于确定全切 NFPA 的可行性,从而更好地制定手术计划和预测术后效果。
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Improving the radiological prediction of surgical resection of nonfunctioning pituitary adenomas.

Purpose: Nonfunctioning pituitary adenomas (NFPAs) are benign tumors growing in the sellar region. Total surgical excision of the lesion is recommended as the preferred treatment choice with preservation of adjacent structures. The objective is to establish a radiological score to predict the feasibility of NFPA total surgical excision.

Methods: Patients with treatment-naïve NFPA who underwent a transsphenoidal approach and sellar magnetic resonance imaging (MRI) in the preoperative period and 3 months after surgery were included. Data on age, sex, tumor diameter, extrasellar extension, postoperative cure rates, and hormone and transcription factor expression were collected. A combined score was proposed based on Knosp and SIPAP classifications. We proposed 3 classification groups depending on the tumoral extension to the suprasellar, infrasellar, anterior and posterior directions of the sellar region.

Results: A total of 164 patients were included in the study, and 85 (52%) were female. Total excision was obtained in 46% (n = 75) of the patients. The majority of tumors were of gonadotrophic lineage (59%), followed by corticotrophic (17%) and other less common types. Largest tumor diameter was 6.8 cm [mean 3.8 cm (± 1.1 cm)]. From the established groups, 10 patients were classified in Group I, of whom 8 (80%) patients underwent total excision, 115 patients were classified in Group II, of whom 58 (50%) underwent complete excision and 39 patients in Group III, of whom 9 (23%) underwent complete excision (p value < 0.001).

Conclusion: The newly proposed score helps to determine the feasibility of total NFPA excision, allowing for better surgical planning and predictions of postoperative outcomes.

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来源期刊
Journal of Endocrinological Investigation
Journal of Endocrinological Investigation ENDOCRINOLOGY & METABOLISM-
CiteScore
8.10
自引率
7.40%
发文量
242
期刊介绍: The Journal of Endocrinological Investigation is a well-established, e-only endocrine journal founded 36 years ago in 1978. It is the official journal of the Italian Society of Endocrinology (SIE), established in 1964. Other Italian societies in the endocrinology and metabolism field are affiliated to the journal: Italian Society of Andrology and Sexual Medicine, Italian Society of Obesity, Italian Society of Pediatric Endocrinology and Diabetology, Clinical Endocrinologists’ Association, Thyroid Association, Endocrine Surgical Units Association, Italian Society of Pharmacology.
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