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垂体ACTH瘤病理评估研究进展

Advances in pathological evaluation of AcTH-secreting pituitary adenomas
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摘要 分泌促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)的垂体腺瘤(垂体ACTH瘤)因过度分泌ACTH刺激双侧肾上腺皮质增生而引起高皮质醇血症,也称作库欣病(Cushing’s disease,CD),是内源性高皮质醇血症最常见的原因。垂体ACTH瘤可导致电解质紊乱,糖、脂代谢紊乱等一系列严重的临床症候群,累及全身多个脏器及系统。经蝶窦神经内镜手术是垂体ACTH瘤的一线治疗方法,可以得到较高的缓解率,但术后复发和持续状态仍然是垂体ACTH瘤治疗的一个未解决的问题。垂体ACTH瘤病理评估在确定病变性质、预测其预后及药物治疗选择方面均有重要的价值。文章就垂体ACTH瘤病理评估的相关进展进行综述,包括新的免疫组化标志物和镜下特殊表现。 Pituitary adenomas secreting adrenocorticotropin hormone(ACTH),known as ACTH-secreting pituitary adenomas,cause hypercortisolism by overproducting ACTH and stimulating bilateral adrenal cortical hyperplasia,a condition also known as Cushing's disease(CD),which is the most common cause of endogenous hypercortisolism.ACTH-secreting pituitary adenomas lead to a series of severe clinical syndromes,including electrolyte disturbances and disorders of glucose and lipid metabolism,affecting multiple organs and systems throughout the body.Transsphenoidal neuroendoscopic surgery is the first-line treatment for ACTH-secreting pituitary adenomas,with a high remission rate,but postoperative recurrence and persistent disease remain unsolved in the treatment of ACTH-secreting pituitary adenomas.The pathological evaluation of ACTH-secreting pituitary adenomas has important value in determining the nature of the lesions,predicting the prognosis,and selecting the drug therapy.This article reviews the advances in the pathologic evaluation of ACTH-secreting pituitary adenomas,including new immunohistochemical markers and microscopic special features.
作者 计铭钰 杨宇宏 孙敏 JI Mingyu;YANG Yuhong;SUN Min(Department of Endocrinology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)
出处 《南京医科大学学报(自然科学版)》 CAS 北大核心 2024年第5期732-737,共6页 Journal of Nanjing Medical University(Natural Sciences)
基金 江苏省卫生健康委员会医学科研重点项目(K2023046)。
关键词 垂体ACTH瘤 库欣病 病理 免疫组化 标志物 ACTH-secreting pituitary adenomas Cushing's disease pathology immunohistochemistry marker
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