Natural history of non-functioning pituitary microadenomas: results from the UK non-functioning pituitary adenoma consortium.

Autor:	Hamblin R; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, United Kingdom.; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TT, United Kingdom.; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2GW, United Kingdom., Fountas A; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, United Kingdom.; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TT, United Kingdom.; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2GW, United Kingdom., Lithgow K; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, United Kingdom.; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TT, United Kingdom.; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2GW, United Kingdom., Loughrey PB; Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, BT12 6BA, United Kingdom.; Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, BT9 7AE, United Kingdom., Bonanos E; Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, BT12 6BA, United Kingdom., Shinwari SK; Department of Endocrinology and Metabolic Medicine, Royal Stoke University Hospital, University Hospitals of North Midlands, Stoke-on-Trent, ST4 6QE, United Kingdom., Mitchell K; Department of Endocrinology, Queen Elizabeth University Hospital, Glasgow, G51 4TF, United Kingdom., Shah S; Department of Endocrinology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L7 8YE, United Kingdom., Grixti L; Department of Endocrinology and Metabolic Medicine, The Newcastle-Upon-Tyne NHS Foundation Trust, Newcastle, NE7 7DN, United Kingdom., Matheou M; Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, United Kingdom., Isand K; Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, United Kingdom., McLaren DS; Leeds Centre for Diabetes & Endocrinology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, United Kingdom., Surya A; Centre for Diabetes and Endocrinology, University Hospital of Wales, Cardiff, CF14 4XW, United Kingdom., Ullah HZ; Centre for Diabetes and Endocrinology, University Hospital of Wales, Cardiff, CF14 4XW, United Kingdom., Klaucane K; Manx Centre for Endocrinology, Diabetes & Metabolism, Manx Care, Douglas, IM4 4RJ, Isle of Man., Jayasuriya A; Department of Endocrinology and Metabolism, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S10 2JF, United Kingdom., Bhatti S; Department of Endocrinology, Norfolk and Norwich University Hospitals Foundation Trust, Norwich, NR4 7UY, United Kingdom., Mavilakandy A; Department of Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, United Kingdom., Ahsan M; Department of Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, United Kingdom., Mathew S; Department of Endocrinology, The Christie NHS Foundation Trust, Manchester, M20 4BX, United Kingdom., Hussein Z; Department of Diabetes & Endocrinology, University College London Hospital NHS Foundation Trust, London, NW1 2PG, United Kingdom., Jansz T; Department of Endocrinology and Metabolism, Royal Devon and Exeter NHS Foundation Trust, Exeter, EX2 5DW, United Kingdom., Wunna W; Department of Endocrinology, St Bartholomew's Hospital, Barts Health NHS Trust, London, EC1A 7BE, United Kingdom., MacFarlane J; Department of Endocrinology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, United Kingdom.; Metabolic Research Laboratories, Wellcome MRC Institute of Metabolic Science, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.; NIHR Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom., Ayuk J; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TT, United Kingdom.; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2GW, United Kingdom., Abraham P; Department of Diabetes and Endocrinology, Aberdeen Royal Infirmary, Aberdeen, AB25 2ZN, United Kingdom., Drake WM; Department of Endocrinology, St Bartholomew's Hospital, Barts Health NHS Trust, London, EC1A 7BE, United Kingdom., Gurnell M; Department of Endocrinology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, United Kingdom.; Metabolic Research Laboratories, Wellcome MRC Institute of Metabolic Science, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.; NIHR Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom., Brooke A; Department of Endocrinology and Metabolism, Royal Devon and Exeter NHS Foundation Trust, Exeter, EX2 5DW, United Kingdom., Baldeweg SE; Department of Diabetes & Endocrinology, University College London Hospital NHS Foundation Trust, London, NW1 2PG, United Kingdom., Sam AH; Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, London, W6 8RF, United Kingdom., Martin N; Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, London, W6 8RF, United Kingdom., Higham C; Department of Endocrinology, The Christie NHS Foundation Trust, Manchester, M20 4BX, United Kingdom.; Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9NQ, United Kingdom., Reddy N; Department of Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, United Kingdom., Levy MJ; Department of Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, United Kingdom., Ahluwalia R; Department of Endocrinology, Norfolk and Norwich University Hospitals Foundation Trust, Norwich, NR4 7UY, United Kingdom., Newell-Price J; Department of Endocrinology and Metabolism, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S10 2JF, United Kingdom.; Department of Oncology and Metabolism, University of Sheffield, Sheffield, S10 2RX, United Kingdom., Vamvakopoulos J; Manx Centre for Endocrinology, Diabetes & Metabolism, Manx Care, Douglas, IM4 4RJ, Isle of Man., Krishnan A; Manx Centre for Endocrinology, Diabetes & Metabolism, Manx Care, Douglas, IM4 4RJ, Isle of Man., Lansdown A; Centre for Diabetes and Endocrinology, University Hospital of Wales, Cardiff, CF14 4XW, United Kingdom., Murray RD; Leeds Centre for Diabetes & Endocrinology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, United Kingdom., Pal A; Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, United Kingdom., Bradley K; Department of Diabetes and Endocrinology, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, BS2 8HW, United Kingdom., Mamoojee Y; Department of Endocrinology and Metabolic Medicine, The Newcastle-Upon-Tyne NHS Foundation Trust, Newcastle, NE7 7DN, United Kingdom., Purewal T; Department of Endocrinology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L7 8YE, United Kingdom., Panicker J; Department of Endocrinology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L7 8YE, United Kingdom., Freel EM; Department of Endocrinology, Queen Elizabeth University Hospital, Glasgow, G51 4TF, United Kingdom., Hasan F; Department of Diabetes and Endocrinology, Royal United Hospitals Bath NHS Foundation Trust, Bath, BA1 3NG, United Kingdom., Kumar M; Department of Endocrinology and Metabolic Medicine, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, WN7 1HS, United Kingdom., Jose B; Department of Endocrinology and Metabolic Medicine, Royal Stoke University Hospital, University Hospitals of North Midlands, Stoke-on-Trent, ST4 6QE, United Kingdom., Hunter SJ; Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, BT12 6BA, United Kingdom., Karavitaki N; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, United Kingdom.; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TT, United Kingdom.; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2GW, United Kingdom.
Jazyk:	angličtina
Zdroj:	European journal of endocrinology [Eur J Endocrinol] 2023 Jul 20; Vol. 189 (1), pp. 87-95.
DOI:	10.1093/ejendo/lvad070
Abstrakt:	Objective: The optimal approach to the surveillance of non-functioning pituitary microadenomas (micro-NFPAs) is not clearly established. Our aim was to generate evidence on the natural history of micro-NFPAs to support patient care. Design: Multi-centre, retrospective, cohort study involving 23 endocrine departments (UK NFPA consortium). Methods: Clinical, imaging, and hormonal data of micro-NFPA cases between January, 1, 2008 and December, 21, 2021 were analysed. Results: Data for 459 patients were retrieved [median age at detection 44 years (IQR 31-57)-152 males/307 females]. Four hundred and nineteen patients had more than two magnetic resonance imagings (MRIs) [median imaging monitoring 3.5 years (IQR 1.71-6.1)]. One case developed apoplexy. Cumulative probability of micro-NFPA growth was 7.8% (95% CI, 4.9%-8.1%) and 14.5% (95% CI, 10.2%-18.8%) at 3 and 5 years, respectively, and of reduction 14.1% (95% CI, 10.4%-17.8%) and 21.3% (95% CI, 16.4%-26.2%) at 3 and 5 years, respectively. Median tumour enlargement was 2 mm (IQR 1-3) and 49% of micro-NFPAs that grew became macroadenomas (nearly all >5 mm at detection). Eight (1.9%) patients received surgery (only one had visual compromise with surgery required >3 years after micro-NFPA detection). Sex, age, and size at baseline were not predictors of enlargement/reduction. At the time of detection, 7.2%, 1.7%, and 1.5% patients had secondary hypogonadism, hypothyroidism, and hypoadrenalism, respectively. Two (0.6%) developed hypopituitarism during follow-up (after progression to macroadenoma). Conclusions: Probability of micro-NFPA growth is low, and the development of new hypopituitarism is rare. Delaying the first follow-up MRI to 3 years and avoiding hormonal re-evaluation in the absence of tumour growth or clinical manifestations is a safe approach for micro-NFPA surveillance. Competing Interests: Conflicts of interest: None declared. (© The Author(s) 2023. Published by Oxford University Press on behalf of European Society of Endocrinology.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu