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当前位置：国际临床研究杂志 > 2018年 2卷 (1)期

Open Access Article

International Journal of Clinical Research. 2018; 2: (1) 1; - ; DOI: DOI:10.12208/j.ijcr.20180001.

Current status of diagnosis and treatment of clinically nonfunctional pituitary adenomas
临床非功能垂体腺瘤的诊疗现状

作者： 龙樱, 詹显全 *

中国湖南省长沙市湘雅路 87 号中南大学湘雅医院卫生部肿瘤蛋白质组学重点实验室、结构生物学与药物设计湖南省工程实验室、抗癌药物国家地方联合工程实验室 ( 邮编 410008)

*通讯作者：詹显全,单位：中国湖南省长沙市湘雅路 8 号中南大学湘雅医院卫生部肿瘤蛋白质组学重点实验室、结构生物学与药物设计湖南省工程实验室、抗癌药物国家地方联合工程实验室 ( 邮编 0008)；

国家高技术“863计划”子项目国家自然科学基金湖南省自然科学基金湖南省百人计划基金（詹显全）湘雅医院人才引进基金（詹显全）

发布时间: 2018-09-09 总浏览量: 4460

PDF 全文下载引用本文收录截图（CNKI-Scholar）

摘要

垂体是人体内分泌系统的重要调控腺体，对于维持内平衡的稳态发挥关键作用。非功能性垂体腺瘤是一种无异常激素分泌的一种疾病，这一特性导致其早期诊断十分困难。随着疾病的发展往往会压迫周围神经产生明显的病征，如出现视力功能障碍、颅神经麻痹和头痛等症状才得以确诊。此时垂体已经发生功能衰减，对内分泌系统的中枢调控作用已经丧失，会对患者产生全身性的影响。本文中主要介绍目前非功能性垂体腺瘤的诊断与治疗的现状，对该类疾病的准确分类与高效治疗提供指导。

关键词： 垂体腺瘤；非功能性垂体腺瘤；诊疗状态

Abstract

Pituitary is an important regulatory gland in human endocrine system and plays a key role in maintaining homeostasis in the body. Non-functional pituitary adenoma is a disease that is free of abnormal hormone secretion, and this feature makes early diagnosis difficult. As the disease develops, it tends to compress the peripheral nerves to produce obvious symptoms, such as visual dysfunction, cranial nerve palsy and headache. At this time, the pituitary has undergone functional attenuation, and the central regulation of the endocrine system has been lost, which will have a systemic effect on the patient. This article mainly introduces the current status of diagnosis and treatment of non-functional pituitary adenomas, and provides guidance for accurate classification and efficient treatment of such diseases.

Key words： Pituitary adenoma；nonfunctional pituitary adenoma；current status of diagnosis and treatment

参考文献 References

[1] Dorton A. The pituitary gland: Embryology, physiology, and pathophysiology.Neonatal Network,2000 19 (2) : 9-17.

[2] Caffarini M, Orciani M, Trementino L, et al. Pituitary adenomas, stem cells, and cancer stem cells: What’s new?.J Endocrinol Investigation,2017 : 1-9.

[3] Nishioka H, Inoshita N, Mete O, et al. The complementary role of transcription factors in the accurate diagnosis of clinically nonfunctioning pituitary adenomas.Endocrine Pathol,2015 26 (4) : 349-355.

[4] Greenman Y. Management of endocrine disease: Present and future perspectives for medical therapy of nonfunctioning pituitary adenomas.Eur J Endocrinol,2017 177 (3) : R113-R124.

[5] Greenman Y, Stern N. Optimal management of non-functioning pituitary adenomas.Endocrine,2015 50 (1) : 51-55.

[6] Greenman Y, Ouaknine G, Veshchev I, et al. Postoperative surveillance of clinically nonfunctioning pituitary macroadenomas: Markers of tumour quiescence and regrowth.Clin Endocrinol,2003 58 (6) : 763-769.

[7] Chen Y, De Wang C, Su ZP, et al. Natural history of postoperative nonfunctioning pituitary adenomas: A systematic review and meta-analysis.Neuroendocrinol,2012 96 (4) : 333-342.

[8] Reddy R, Cudlip S, Byrne JV, et al. Can we ever stop imaging in surgically treated and radiotherapy-naive patients with non-functioning pituitary adenoma?.Eur J Endocrinol,2011 165 (5) : 739-744.

[9] O’Sullivan EP, Woods C, Glynn N, et al. The natural history of surgically treated but radiotherapy‐naïve nonfunctioning pituitary adenomas.Clin Endocrinol,2009 71 (5) : 709-714.

[10] McLaughlin N, Eisenberg AA, Cohan P, et al. Value of endoscopy for maximizing tumor removal in endonasal transsphenoidal pituitary adenoma surgery.J Neurosurg,2013 118 (3) : 613-620.

[11] Messerer M, De Battista JC, Raverot G, et al. Evidence of improved surgical outcome following endoscopy for nonfunctioning pituitary adenoma removal: Personal experience and review of the literature.Neurosurg Focus,2011 30 (4) : E11.

[12] Buchfelder M, Schlaffer S. Intraoperative magnetic resonance imaging for pituitary adenomas.Front Horm Res,2016 45 : 211.

[13] Berkmann S, Schlaffer S, Nimsky C, et al. Follow-up and long-term outcome of nonfunctioning pituitary adenoma operated by transsphenoidal surgery with intraoperative high-field magnetic resonance imaging.Acta Neurochirurgica,2014 156 (12) : 2233-2243.

[14] Kuo JS, Barkhoudarian G, Farrell CJ, et al. Congress of neurological surgeons systematic review and evidence-based guideline on surgical techniques and technologies for the management of patients with nonfunctioning pituitary adenomas.Neurosurg,2016 79 (4) : E536-538.

[15] Zhan X, Wang X, Long Y, et al. Heterogeneity analysis of the proteomes in clinically nonfunctional pituitary adenomas.BMC Medical Genomics,2014 7 (1) : 69.

[16] Nishioka H, Inoshita N. New who classification of pituitary adenomas: Assessment of pituitary transcription factors and the prognostic histological factors.Brain Tumor Pathol,2018 : 1-5.

[17] Saeger W, Lüdecke DK, Buchfelder M, et al. Pathohistological classification of pituitary tumors: 10 years of experience with the german pituitary tumor registry.Eur J Endocrinol,2007 156 (2) : 203-213.

[18] Asa SL. Practical pituitary pathology: What does the pathologist need to know?.Arch Pathol Lab Med,2008 132 (8) : 1231-1240.

[19] Mete O, Asa SL. Clinicopathological correlations in pituitary adenomas.Brain Pathol,2012 22 (4) : 151-156.

[20] Nishioka H, Inoshita N, Sano T, et al. Correlation between histological subtypes and mri findings in clinically nonfunctioning pituitary adenomas.Endocrine Pathol,2012 23 (3) : 151-156.

[21] Erickson D, Scheithauer B, Atkinson J, et al. Silent subtype 3 pituitary adenoma: A clinicopathologic analysis of the mayo clinic experience.Clin Endocrinol,2009 71 (1) : 92-99.

[22] Balogun JA, Monsalves E, Juraschka K, et al. Null cell adenomas of the pituitary gland: An institutional review of their clinical imaging and behavioral characteristics.Endocrine Pathol,2015 26 (1) : 63-70.

[23] Bradley K, Wass J, Turner H. Non‐functioning pituitary adenomas with positive immunoreactivity for acth behave more aggressively than acth immunonegative tumours but do not recur more frequently.Clin Endocrinol,2003 58 (1) : 59-64.

[24] Mete O, Gomez-Hernandez K, Kucharczyk W, et al. Silent subtype 3 pituitary adenomas are not always silent and represent poorly differentiated monomorphous plurihormonal pit-1 lineage adenomas.Modern Pathol,2016 29 (2) : 131.

[25] Brochier S, Galland F, Kujas M, et al. Factors predicting relapse of nonfunctioning pituitary macroadenomas after neurosurgery: A study of 142 patients.Eur J Endocrinol,2010 163 (2) : 193-200.

[26] Tateno T, Kato M, Tani Y, et al. Differential expression of somatostatin and dopamine receptor subtype genes in adrenocorticotropin (acth)-secreting pituitary tumors and silent corticotroph adenomas.Endocrine J,2009 56 (4) : 579-584.

[27] Petrossians P, Ronci N, Socin HV, et al. Acth silent adenoma shrinking under cabergoline.Eur J Endocrinol,2001 144 (1) : 51-57.

[28] Kanner AA, Corn BW, Greenman Y. Radiotherapy of nonfunctioning and gonadotroph adenomas.Pituitary,2009 12 (1) : 15-22.

[29] Darzy KH, Shalet SM. Hypopituitarism as a consequence of brain tumours and radiotherapy.Pituitary,2005 8 (3-4) : 203-211.

[30] Minniti G, Traish D, Ashley S, et al. Risk of second brain tumor after conservative surgery and radiotherapy for pituitary adenoma: Update after an additional 10 years.J Clin Endocrinol Metab,2005 90 (2) : 800-804.

[31] Erfurth EM, Bülow B, Svahn-Tapper G, et al. Risk factors for cerebrovascular deaths in patients operated and irradiated for pituitary tumors.J Clin Endocrinol Metab,2002 87 (11) : 4892-4899.

[32] Minniti G, Jaffrain-Rea M-L, Osti M, et al. Radiotherapy for nonfunctioning pituitary adenomas: From conventional to modern stereotactic radiation techniques.Neurosurg Rev,2007 30 (3) : 167-176.

[33] Sheehan JP, Starke RM, Mathieu D, et al. Gamma knife radiosurgery for the management of nonfunctioning pituitary adenomas: A multicenter study.J Neurosurg,2013 119 (2) : 446-456.

[34] Minniti G, Scaringi C, Poggi M, et al. Fractionated stereotactic radiotherapy for large and invasive non-functioning pituitary adenomas: Long-term clinical outcomes and volumetric mri assessment of tumor response.Eur J Endocrinol,2015 172 (4) : 433-441.

[35] Honegger J, Prettin C, Feuerhake F, et al. Expression of ki-67 antigen in nonfunctioning pituitary adenomas: Correlation with growth velocity and invasiveness.J Neurosurg,2003 99 (4) : 674-679.

[36] Olsson DS, Nilsson AG, Bryngelsson I-L, et al. Excess mortality in women and young adults with nonfunctioning pituitary adenoma: A swedish nationwide study.J Clin Endocrinol Metab,2015 100 (7) : 2651-2658.

[37] Florio T, Barbieri F, Spaziante R, et al. Efficacy of a dopamine–somatostatin chimeric molecule, bim-23a760, in the control of cell growth from primary cultures of human non-functioning pituitary adenomas: A multi-center study.Endocrine-Related Cancer,2008 15 (2) : 583-596.

[38] Greenman Y, Tordjman K, Osher E, et al. Postoperative treatment of clinically nonfunctioning pituitary adenomas with dopamine agonists decreases tumour remnant growth.Clin Endocrinol,2005 63 (1) : 39-44.

[39] Greenman Y, Cooper O, Yaish I, et al. Treatment of clinically nonfunctioning pituitary adenomas with dopamine agonists.Eur J Endocrinol,2016 175 (1) : 63-72.

[40] Colao A, Di Somma C, Pivonello R, et al. Medical therapy for clinically non-functioning pituitary adenomas.Endocrine-Related Cancer,2008 15 (4) : 905-915.

[41] Greenman Y, Melmed S. Expression of three somatostatin receptor subtypes in pituitary adenomas: Evidence for preferential sstr5 expression in the mammosomatotroph lineage.J Clin Endocrinol Metab,1994 79 (3) : 724-729.

[42] Taboada GF, Luque RM, Bastos W, et al. Quantitative analysis of somatostatin receptor subtype (sstr1–5) gene expression levels in somatotropinomas and non-functioning pituitary adenomas.Eur J Endocrinol,2007 156 (1) : 65-74.

[43] Zatelli MC, Piccin D, Bottoni A, et al. Evidence for differential effects of selective somatostatin receptor subtype agonists on α-subunit and chromogranin a secretion and on cell viability in human nonfunctioning pituitary adenomas in vitro.J Clin Endocrinol Metab,2004 89 (10) : 5181-5188.

[44] Florio T, Thellung S, Arena S, et al. Somatostatin and its analog lanreotide inhibit the proliferation of dispersed human non-functioning pituitary adenoma cells in vitro.Eur J Endocrinol,1999 141 (4) : 396-408.

[45] Luque RM, Ibáñez-Costa A, Neto LV, et al. Truncated somatostatin receptor variant sst5tmd4 confers aggressive features (proliferation, invasion and reduced octreotide response) to somatotropinomas.Cancer Lett,2015 359 (2) : 299-306.

[46] Zatelli MC, Piccin D, Vignali C, et al. Pasireotide, a multiple somatostatin receptor subtypes ligand, reduces cell viability in non-functioning pituitary adenomas by inhibiting vascular endothelial growth factor secretion.Endocrine-Related Cancer,2007 14 (1) : 91-102.

[47] Lee M, Lupp A, Mendoza N, et al. Sstr3 is a putative target for the medical treatment of gonadotroph adenomas of the pituitary.Endocrine-Related Cancer,2015 22 (1) : 111-119.

[48] Sharma K, Patel YC, Srikant CB. Subtype-selective induction of wild-type p53 and apoptosis, but not cell cycle arrest, by human somatostatin receptor 3.Mol Endocrinol,1996 10 (12) : 1688-1696.

[49] Theodoropoulou M, Stalla GK. Somatostatin receptors: From signaling to clinical practice.Front Neuroendocrinol,2013 34 (3) : 228-252.

[50] Fleseriu M. Medical treatment of cushing disease: New targets, new hope.Endocrinol Metab Clin,2015 44 (1) : 51-70.

[51] chmid HA, Brue T, Colao A, et al. Effect of pasireotide on glucose-and growth hormone-related biomarkers in patients with inadequately controlled acromegaly.Endocrine,2016 53 (1) : 210-219.

[52] Raverot G, Sturm N, De Fraipont F, et al. Temozolomide treatment in aggressive pituitary tumors and pituitary carcinomas: A french multicenter experience.J Clin Endocrinol Metab,2010 95 (10) : 4592-4599.

[53] Hirohata T, Asano K, Ogawa Y, et al. DNA mismatch repair protein (msh6) correlated with the responses of atypical pituitary adenomas and pituitary carcinomas to temozolomide: The national cooperative study by the japan society for hypothalamic and pituitary tumors.J Clin Endocrinol Metab,2013 98 (3) : 1130-1136.

[54] Zhao Y, Xiao Z, Chen W, et al. Disulfiram sensitizes pituitary adenoma cells to temozolomide by regulating o6-methylguanine-DNA methyltransferase expression.Mol Med Rep,2015 12 (2) : 2313-2322.

[55] Dai C, Zhang B, Liu X, et al. Pyrimethamine sensitizes pituitary adenomas cells to temozolomide through cathepsin b‐dependent and caspase‐dependent apoptotic pathways.Int J Cancer,2013 133 (8) : 1982-1993.

[56] Kun Z, Yuling Y, Dongchun W, et al. Hif-1α inhibition sensitized pituitary adenoma cells to temozolomide by regulating presenilin 1 expression and autophagy.Tech Cancer Res Treat,2016 15 (6) : NP95-NP104.

[57] Bergsma H, van Vliet EI, Teunissen JJ, et al. Peptide receptor radionuclide therapy (prrt) for gep-nets.Best Pract Res Clin Gastroenterol,2012 26 (6) : 867-881.

[58] Maclean J, Aldridge M, Bomanji J, et al. Peptide receptor radionuclide therapy for aggressive atypical pituitary adenoma/carcinoma: Variable clinical response in preliminary evaluation.Pituitary,2014 17 (6) : 530-538.

[59] Komor J, Reubi JC, Christ ER. Peptide receptor radionuclide therapy in a patient with disabling non-functioning pituitary adenoma.Pituitary,2014 17 (3) : 227-231.

[60] Sun L-C, H Coy D. Somatostatin receptor-targeted anti-cancer therapy.Curr Drug Delivery,2011 8 (1) : 2-10.

[61] Lelle M, Kaloyanova S, Freidel C, et al. Octreotide-mediated tumor-targeted drug delivery via a cleavable doxorubicin–peptide conjugate.Mol Pharmaceutics,2015 12 (12) : 4290-4300.

[62] Ledermann J, Canevari S, Thigpen T. Targeting the folate receptor: Diagnostic and therapeutic approaches to personalize cancer treatments.Ann Oncol,2015 26 (10) : 2034-2043.

[63] Evans C-O, Reddy P, Brat DJ, et al. Differential expression of folate receptor in pituitary adenomas.Cancer Res,2003 63 (14) : 4218-4224.

[64] Liu X, Ma S, Yao Y, et al. Differential expression of folate receptor alpha in pituitary adenomas and its relationship to tumor behavior.Neurosurg,2011 70 (5) : 1274-1280.

[65] Liu X, Ma S, Dai C, et al. Antiproliferative, antiinvasive, and proapoptotic activity of folate receptor α-targeted liposomal doxorubicin in nonfunctional pituitary adenoma cells.Endocrinol,2013 154 (4) : 1414-1423.

[66] Dworakowska D, Wlodek E, Leontiou C, et al. Activation of raf/mek/erk and pi3k/akt/mtor pathways in pituitary adenomas and their effects on downstream effectors.Endocrine-Related Cancer,2009 16 (4) : 1329-1338.

[67] Noh T-W, Jeong HJ, Lee M-K, et al. Predicting recurrence of nonfunctioning pituitary adenomas.J Clin Endocrinol Metab,2009 94 (11) : 4406-4413.

[68] Jia W, Sanders AJ, Jia G, et al. Expression of the mtor pathway regulators in human pituitary adenomas indicates the clinical course.Anticancer Res,2013 33 (8) : 3123-3131.

[69] Rubinfeld H, Shimon I. Pi3k/akt/mtor and raf/mek/erk signaling pathways perturbations in non-functioning pituitary adenomas.Endocrine,2012 42 (2) : 285-291.

[70] Zatelli MC, Minoia M, Filieri C, et al. Effect of everolimus on cell viability in nonfunctioning pituitary adenomas.J Clin Endocrinol Metab,2010 95 (2) : 968-976.

[71] Lee M, Wiedemann T, Gross C, et al. Targeting pi3k/mtor signaling displays potent antitumor efficacy against nonfunctioning pituitary adenomas.Clin Cancer Res,2015 21 (14) : 3204-3215.

[72] Cerovac V, Monteserin-Garcia J, Rubinfeld H, et al. The somatostatin analogue octreotide confers sensitivity to rapamycin treatment on pituitary tumor cells.Cancer Res,2010 70 (2) : 666-674.

[73] Jouanneau E, Wierinckx A, Ducray F, et al. New targeted therapies in pituitary carcinoma resistant to temozolomide.Pituitary,2012 15 (1) : 37-43.

引用本文

龙樱, 詹显全, 临床非功能垂体腺瘤的诊疗现状[J]. 国际临床研究杂志, 2018; 2: (1) : -.

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