摘要
Abstract
Objective:One of the major endocrine manifestations of male pituitary prolactinoma(PLA)is dysfunction of the hypothalamic-pituitary-gonad(HPG)axis.This study aims to analyze the outcomes of HPG axis function in male PLA patients undergoing different treatment strategies.
Methods:A retrospective case series study was conducted,including 43 male PLA patients treated at the Department of Endocrinology,Beijing Tiantan Hospital affiliated to Capital Medical University,between January 2015 and January 2019.The mean age was(37.2±12.1)years.The median maximum tumor diameter was 30(21,40)mm,and the median prolactin(PRL)level was 1 859.0(1 098.0,3 949.0)ng/mL.The median follow-up duration was 11.0(3.4,18.8)months.Patients were categorized into 3 groups:A medication therapy group,a surgery combined with medication group,and a radiotherapy combined with medication group.
Results:The primary manifestation of male PLA was impairment of HPG axis function,with a baseline dysfunction rate of 76.7%(33/43).At the last follow-up,the PRL normalization rate was 30.4%(7/23)in the medication group,with HPG axis dysfunction decreasing from 91.3%(21/23)to 65.2%(15/23).In the surgery combined with medication group,PRL normalization reached 41.2%(7/17),but HPG axis dysfunction increased from 58.8%(10/17)to 64.7%(11/17).In the radiotherapy combined with medication group,although PRL levels significantly decreased,HPG axis function showed no significant improvement and in some cases worsened.Tumor maximum diameter may be an independent risk factor for poor HPG axis recovery(P=0.020).
Conlusion:Medication therapy is more effective in reducing PRL levels and improving HPG axis function.Surgical treatment can also effectively reduce PRL levels and may help restore HPG axis function in some patients;however,postoperative medication is typically required for disease control.Radiotherapy appears less effective in restoring HPG axis function.关键词
男性垂体催乳素腺瘤/下丘脑-垂体-性腺轴/药物治疗/手术治疗/放射治疗Key words
male pituitary prolactinoma/hypothalamic-pituitary-gonad axis/medication therapy/surgical treatment/radiotherapy
