垂体神经内分泌肿瘤是一种常见的颅内肿瘤,治疗方式主要为经蝶或经颅垂体瘤切除术,对于手术治疗的患者,术后是否复发会影响患者后续治疗方案以及生存预后,其中侵入鞍上或鞍旁区域的PitNET由于术中难以完全切除,术后12%~58%的患者会出现...垂体神经内分泌肿瘤是一种常见的颅内肿瘤,治疗方式主要为经蝶或经颅垂体瘤切除术,对于手术治疗的患者,术后是否复发会影响患者后续治疗方案以及生存预后,其中侵入鞍上或鞍旁区域的PitNET由于术中难以完全切除,术后12%~58%的患者会出现复发(本文复发定义采用2019年中国复发性垂体腺瘤诊治专家共识中的定义:垂体腺瘤切除术后已消失的症状体征再次出现;内分泌指标达到缓解标准后再次升高;影像学检查再次出现肿瘤生长),即使瘤体被完全切除,10%~20%仍会在5~10年内复发。肿瘤的复发给患者带来经济和心理负担的同时降低了其生活质量。本文主要从影像学特征、病理学因素及其他因素三方面对术后PitNET复发的因素进行综述,以及对临床中PitNET的治疗方式提出个人建议,旨在为该病的临床治疗提供参考。Pituitary neuroendocrine tumor is a common intracranial tumor, and the treatment is mainly transsphenoidal or transcranial pituitary tumor resection. For patients undergoing surgical treatment, whether postoperative recurrence will affect the follow-up treatment plan and survival prognosis of the patients. Among them, the PitNET that invaded the suprasellar or parasellar area was difficult to be completely removed during surgery, and recurred in 12%~58% of patients after surgery. (In this paper, the definition of relapse was adopted in the expert consensus on diagnosis and treatment of recurrent pituitary adenoma in China in 2019: symptoms and signs that had disappeared after pituitary adenoma resection reappeared;Endocrine indexes increased again after reaching the remission standard;Tumor growth reappears on imaging.) And even if the tumor is completely removed, 10%~20% will recur within 5 to 10 years. The recurrence of tumors brings financial and psychological burden to patients and reduces their quality of life. This article mainly reviews the factors of postoperative recurrence of PitNET from three aspects: imaging features, pathological factors and other factors, and puts forward personal suggestions on the clinical treatment of PitNET, aiming at providing references for the clinical treatment of this disease.展开更多
文摘垂体神经内分泌肿瘤是一种常见的颅内肿瘤,治疗方式主要为经蝶或经颅垂体瘤切除术,对于手术治疗的患者,术后是否复发会影响患者后续治疗方案以及生存预后,其中侵入鞍上或鞍旁区域的PitNET由于术中难以完全切除,术后12%~58%的患者会出现复发(本文复发定义采用2019年中国复发性垂体腺瘤诊治专家共识中的定义:垂体腺瘤切除术后已消失的症状体征再次出现;内分泌指标达到缓解标准后再次升高;影像学检查再次出现肿瘤生长),即使瘤体被完全切除,10%~20%仍会在5~10年内复发。肿瘤的复发给患者带来经济和心理负担的同时降低了其生活质量。本文主要从影像学特征、病理学因素及其他因素三方面对术后PitNET复发的因素进行综述,以及对临床中PitNET的治疗方式提出个人建议,旨在为该病的临床治疗提供参考。Pituitary neuroendocrine tumor is a common intracranial tumor, and the treatment is mainly transsphenoidal or transcranial pituitary tumor resection. For patients undergoing surgical treatment, whether postoperative recurrence will affect the follow-up treatment plan and survival prognosis of the patients. Among them, the PitNET that invaded the suprasellar or parasellar area was difficult to be completely removed during surgery, and recurred in 12%~58% of patients after surgery. (In this paper, the definition of relapse was adopted in the expert consensus on diagnosis and treatment of recurrent pituitary adenoma in China in 2019: symptoms and signs that had disappeared after pituitary adenoma resection reappeared;Endocrine indexes increased again after reaching the remission standard;Tumor growth reappears on imaging.) And even if the tumor is completely removed, 10%~20% will recur within 5 to 10 years. The recurrence of tumors brings financial and psychological burden to patients and reduces their quality of life. This article mainly reviews the factors of postoperative recurrence of PitNET from three aspects: imaging features, pathological factors and other factors, and puts forward personal suggestions on the clinical treatment of PitNET, aiming at providing references for the clinical treatment of this disease.
