解放军医学杂志2017，Vol.42Issue(7)：591-596,6.DOI:10.11855/j.issn.0577-7402.2017.07.03
垂体促甲状腺激素分泌瘤临床特点的比较分析
A comparative study of the clinical features of thyrotropin-secreting pituitary adenomas
范晓静 1王先令 1吕朝晖 1巴建明 1窦京涛 1母义明 1臧丽 1金楠 1杜锦 1王琳 1谷伟军 1陈康 1杨国庆 1郭清华1
作者信息
- 1. 100853 北京 解放军总医院内分泌科
- 折叠
摘要
Abstract
Objective To comparatively analyze the clinical characteristics of thyrotropin-secreting pituitary adenomas (TSH-omas).Methods The clinical features, laboratory variables, imaging and pathological Results were retrospectively compared and analyzed of 26 cases with TSH-omas admitted in Chinese PLA General Hospital from Feb. 2006 to Oct. 2016 and 20 cases with TSH-omas admitted in Shanghai Huashan Hospital from Apr. 2006 to Apr. 2013.Results The female ratio was slightly higher in patients of Chinese PLA General Hospital than in Huashan Hospital [(57.7%(15/26)vs. 45.0%(9/20)], while the mean age was similar [39.5±14.1(18-67 years)vs. 40.0±14.5(17-74 years)]. The most common chief complaint was thyrotoxicosis [73.1%(19/26)vs. 55.0%(11/20)], and mild-to-moderate goiter was the most common symptom. The mean serum TSH levels in Chinese PLA General Hospital and in Huashan Hospital were 5.06(2.97-6.27)mU/L and 6.16(3.76-10.91)mU/L respectively, and patients with normal serum TSH levels were more common in Chinese PLA General Hospital than in Huashan Hospital [57.7%(15/26)vs. 40.0%(8/20)]. Microadenoma was more common in Chinese PLA General Hospital than in Huashan Hospital [34.62%(9/26)vs. 20.0%(4/20)], while macroadenoma was more common in Huashan Hospital than in Chinese PLA General Hospital [20.0%(4/20)vs. 7.7%(2/26)]. Microadenoma was more common in female patients of the both groups [66.7%(6/9)vs. 75.0%(3/4)], while macroadenoma was all found in male patients. Tumor invasion of surrounding tissue and structure was often found in macroadenoma. In terms of octreotide inhibition test, the range of 24h TSH inhibition rate was roughly the same in the two groups (37.4%-91.8% and 46.5%-94.1%, respectively). Mixed adenoma was rare among all the pathologically confirmed cases. In Chinese PLA General Hospitals, TSH immunoreactive negative neoplastic cells were found in 3 of 8 cases, and octreotide scanning showed negative in 2 of 12 cases.Conclusions Patients with TSH-omas in the two hospitals show similarities but also some significant differences in the clinical features. Overall, the domestic patients with TSH-omas are diagnosed without gender difference according to the reports in China. The mean age at diagnosis is significantly younger than that in foreign data. Microadenoma is more common in females, while macroadenoma is more common in males. Serum TSH levels can be normal in patients with TSH-omas. Immunostaining and/or octreotide scanning for TSH can be negative.关键词
促甲状腺激素分泌瘤/甲状腺功能亢进症/垂体肿瘤/临床特点Key words
thyrotropin-secreting pituitary adenoma/hyperthyroidism/pituitary neoplasma/clinical characteristics分类
医药卫生引用本文复制引用
范晓静,王先令,吕朝晖,巴建明,窦京涛,母义明,臧丽,金楠,杜锦,王琳,谷伟军,陈康,杨国庆,郭清华..垂体促甲状腺激素分泌瘤临床特点的比较分析[J].解放军医学杂志,2017,42(7):591-596,6.
