Pituitary adenoma: nws yog dab tsi, lub ntsiab ua thiab kev kho mob

Zoo Siab

• Cov tsos mob tseem ceeb
• 1. Lactotrophic adenoma
• 2. Somatotrophic adenoma
• 3. Corticotrophic adenoma
• 4. Gonadotrophic adenoma
• 5. Thyrotrophic adenoma
• 6. Tsis-secreting adenoma
• Ua rau ntawm pituitary adenoma
• Yuav ua li cas kom paub meej tias kuaj mob
• Yuav kho tus mob li cas
• Kev phais mob
• Cov tshuaj kho mob

Pituitary adenoma, tseem hu ua pituitary adenoma, yog ib hom qog benign pituitary qog, nws yog cov qog nyob rau hauv lub hlwb thiab ua lub luag haujlwm tswj kev tsim cov tshuaj hormones xws li cortisol, prolactin, kev loj hlob hormone thiab cov tshuaj hormones uas txhawb kev ua haujlwm ntawm zes qe menyuam thiab noob qes. , piv txwv li.

Hom qog no muaj tsawg tsawg thiab, vim tias nws yog benign, tsis ua rau muaj kev phom sij txog lub neej, txawm li cas los xij nws tuaj yeem ua rau cov tsos mob uas ua rau lub neej txo qis xws li tsis muaj zog, txo qis libido, kev tsim mis lossis cov tsos mob hlwb xws li mob taub hau lossis ib nrab ploj. kev pom kev.

Thaum twg cov tsos mob tshwm sim uas yuav qhia txog qhov muaj adenoma hauv lub caj pas pituitary, nws yog qhov tseem ceeb rau sab laj nrog tus kws kho mob endocrinologist, tus kws kho mob hlwb lossis oncologist coj mus kuaj mob, txheeb xyuas qhov teeb meem thiab pib kho kom tsim nyog tshaj plaws.

Cov tsos mob tseem ceeb

Feem ntau, cov tsos mob tshwm sim ntawm pituitary adenoma yog mob taub hau, tsis pom kev, tsis tshua muaj kev sib deev thiab hloov hauv lub cev ntas rau poj niam.

Txawm li cas los xij, muaj lwm cov tsos mob uas tuaj yeem tshwm sim thiab uas txawv raws li hom tshuaj hormone uas cuam tshuam los ntawm adenoma:

1. Lactotrophic adenoma

Lactotrophic pituitary adenoma yog tus cwj pwm los ntawm hyperprolactinemia, uas yog qhov nce ntawm hormone prolactin, lub luag haujlwm rau kev tsim mis nyuj. Hauv hom adenoma no tus tsos mob tseem ceeb yog kev tsim kua mis hauv lub mis ntawm tus txiv neej lossis tus poj niam uas tsis pub niam mis.

Ntxiv rau, lwm cov tsos mob uas tuaj yeem tshwm sim yog kev xav tsis txaus siab txog kev sib deev, tsis muaj menyuam, kev coj khaub ncaws lossis tus txiv neej tsis muaj zog.

2. Somatotrophic adenoma

Somatotrophic pituitary adenoma yog cov yam ntxwv ntawm kev loj hlob ntau lawm thiab tuaj yeem ua rau qhov nce thiab tuab ntawm cov ntiv tes thiab ntiv taw, ntxiv rau qhov nce ntawm lub hauv pliaj, lub puab tsaig thiab lub qhov ntswg uas hloov cov duab ntawm lub ntsej muag. Tus mob no yog hu ua acromegaly, rau cov neeg laus, lossis gigantism, hauv cov menyuam yaus.

Ntxiv rau, lwm cov tsos mob uas yuav tshwm sim suav nrog kev mob sib koom tes, leeg tsis muaj zog, txo qis kev sib deev, hloov lub cev ntas, tawm hws ntau ntxiv lossis nkees.

3. Corticotrophic adenoma

Corticotrophic pituitary adenoma cuam tshuam rau kev tsim cov tshuaj hormone cortisol, uas yog lub luag haujlwm ua kom cov ntshav qabzib nce thiab tso nyiaj ntawm cov rog hauv cov nqaij thiab kabmob.

Feem ntau, hom mob qog nqaij hlav hauv pob zeb tuaj yeem ua rau Cushing's syndrome uas ua rau cov tsos mob nyhav sai sai, nthuav tawm ntawm cov rog ntawm lub ntsej muag thiab sab nraub qaum, mob nqaij tsis muaj zog, plaub hau ntawm pob ntseg thiab tawv nqaij muaj teeb meem xws li pob txuv thiab kho tsis zoo, piv txwv.

Ntxiv rau, hom adenoma pituitary tuaj yeem ua rau kev nyuaj siab thiab lub siab lub ntsws.

4. Gonadotrophic adenoma

Gonadotrophic pituitary adenoma cuam tshuam txog kev tsim cov tshuaj hormones ntau ntxiv uas tswj kev ovulation rau poj niam thiab cov phev ntau lawm hauv txiv neej. Txawm li cas los xij, hom mob pituitary adenoma tsis muaj cov tsos mob tshwj xeeb.

5. Thyrotrophic adenoma

Thyrotrophic adenoma yog hom pituitary adenoma nyob rau hauv uas muaj kev nce ntxiv hauv kev tsim cov thyroid hormones uas tuaj yeem ua rau hyperthyroidism. Piv txwv li cov tsos mob ntawm lub caj pas pituitary adenoma muaj xws li ua rau lub plawv dhia ceev, poob siab, ntxhov siab, poob phaus, tshee lossis lub ntsej muag ntawm lub pob muag, piv txwv.

6. Tsis-secreting adenoma

Qhov tsis yog-secretory pituitary adenoma yog hom pituitary adenoma tsis cuam tshuam nrog kev tsim cov tshuaj hormones, tsis ua rau muaj kev nce ntxiv hauv cov tshuaj hormones thiab feem ntau tsis muaj tsos mob tshwm sim. Txawm li cas los xij, yog tias lub adenoma tseem pheej loj ntxiv, nws tuaj yeem tso lub siab rau lub caj pas pituitary thiab ua rau muaj kev hloov hauv keeb kwm.

Ua rau ntawm pituitary adenoma

Cov laj thawj ntawm pituitary adenoma tseem tsis tau paub, txawm li cas los xij qee qhov kev tshawb fawb qhia tias hom qog no tuaj yeem tshwm sim vim hloov DNA ntawm cov hlwb lossis hauv cov neeg uas muaj lwm yam kev pheej hmoo xws li:

• Ntau tus kab mob endocrine neoplasia: cov tsos mob no yog ib qho kev mob uas tsis tshua muaj muaj los ntawm kev hloov pauv hauv DNA uas ua rau qog lossis nce ntxiv ntawm ntau cov qog hauv lub cev, nrog rau lub qog pituitary, uas tuaj yeem ua rau muaj kev pheej hmoo ntawm pituitary adenoma;
• McCune-Albright mob: qhov tsis tshua muaj keeb caj ces tshwm sim vim qhov hloov pauv ntawm DNA thiab tuaj yeem ua rau kev hloov pauv ntawm cov tshuaj hormones ntawm lub caj pas pituitary thiab, ntxiv rau cov teeb meem hauv cov pob txha thiab tawv nqaij;
• Carney Complex: yog muaj tsawg kawg ntawm cov mob caj dab malignant syndrome uas tuaj yeem ua rau pituitary adenoma thiab lwm yam mob qog nqaij hlav xws li prostate lossis thyroid thiab hlwv ntawm zes qe menyuam.

Ntxiv rau, hluav taws xob tiv thaiv hluav taws xob tuaj yeem ua rau muaj kev pheej hmoo ntawm kev hloov pauv hauv DNA thiab kev txhim kho ntawm pituitary adenoma.

Yuav ua li cas kom paub meej tias kuaj mob

Kev kuaj mob ntawm tus kab mob pituitary adenoma yog ua los ntawm tus kws kho paj hlwb lossis kws kho pob txha raws li cov tsos mob thiab kuaj sim txhawm rau txheeb xyuas cov tshuaj hormones ntau ntau thiab suav nrog:

• Cortisol hauv zis, qaub ncaug lossis ntshav;
• Luteotrophic hormone thiab follicle stimulating hormone hauv cov ntshav;
• Prolactin hauv ntshav;
• Glycemic nkhaus;
• Cov thyroid hormones txaus nyiam TSH, T3 thiab T4 hauv cov ntshav.

Tsis tas li ntawd, txhawm rau paub meej tias kev kuaj mob, tus kws kho mob tuaj yeem thov MRI ntawm lub caj pas pituitary.

Yuav kho tus mob li cas

Kev kho ntawm pituitary adenoma tuaj yeem ua tiav nrog kev siv tshuaj kho mob lossis phais thiab nyob ntawm hom adenoma thiab qhov loj ntawm lub qog:

Kev phais mob

Kev phais mob yog qhia thaum pituitary adenoma tsis yog-cov ntawv zais thiab ntau dua 1 cm. Tsis tas li ntawd, hauv qhov no kev kho mob phais yog tsuas yog qhia yog tias tus tsos mob ntawm qhov poob lossis hloov pauv hauv lub zeem muag tshwm sim.

Thaum cov qog tsis ua kom tsis pub neeg siv tsawg dua 1 cm los yog tsis muaj cov tsos mob, kev kho yog ua tiav nrog kev soj ntsuam kev kho mob thiab cov duab sib nqus resonance los soj ntsuam kev loj hlob ntawm cov qog mus tas li. yog tias tsim nyog, tus kws kho mob yuav pom zoo kom siv cov tshuaj kho lossis phais.

Tsis tas li ntawd, rau cov pituitary adenomas nyob rau hauv kev loj hlob hormone los yog cortisol hloov, kev phais kuj tseem qhia tau, nrog rau kev siv tshuaj kho mob.

Cov tshuaj kho mob

Cov tshuaj uas siv los kho adenoma sib txawv nrog hom adenoma thiab suav nrog:

• Pegvisomanto, octreotide lossis lanreotide: qhia rau somatotrophic adenoma;
• Ketoconazole lossis mitotane: qhia rau corticotrophic adenoma;
• Cabergoline lossis bromocriptine: qhia rau lactotrophic adenoma.

Ntxiv rau, tus kws kho mob tuaj yeem pom zoo rau kev tua hluav taws xob hauv tsev neeg ntawm somatotrophic lossis corticotrophic adenoma.