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The acromegaly registry of ten different centers in Turkey.
Growth Hormone and IGF Research ( IF 1.4 ) Pub Date : 2020-04-27 , DOI: 10.1016/j.ghir.2020.101322
Çağlar Keskin 1 , Özgür Demir 1 , Alper Çağrı Karcı 2 , Dilek Berker 2 , Zeynep Cantürk 3 , Güzin Fidan Yaylali 4 , Şenay Topsakal 4 , Reyhan Ersoy 5 , Fahri Bayram 6 , Melek Eda Ertörer 7 , Emre Bozkırlı 7 , Filiz Haydardedeoğlu 7 , Esra Nur Ademoğlu Dilekçi 8 , Seyid Ahmet Ay 9 , Güven Barış Cansu 10 , Mustafa Şahin 1 , Rıfat Emral 1 , Demet Çorapçıoğlu 1
Affiliation  

Objectives

To describe biochemical and clinical features, and therapeutic outcomes of acromegaly patients in Turkey.

Methods

Retrospective multicenter epidemiological study of 547 patients followed in 10 centers of the Turkish Acromegaly registry.

Results

A total of 547 acromegaly patients (55% female) with a median age of 41 was included in this study. Majority of patients had a macroadenoma (78%). Transsphenoidal surgery was performed as primary treatment in 92% of the patients (n = 503). Surgical remission rate was 39% (197/503) in all operated patients. Overall disease control was achieved in 70% of patients. Remission group were significantly older than non-remission group (p = .002). Patients with microadenomas had significantly higher remission rates than patients with macroadenomas (p < .001). Patients with microadenomas were significantly older at the time of diagnosis when compared to patients with macroadenomas (p < .001). Preoperative growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels were significantly lower in the remission group (p < .001). Initial IGF-1 and GH levels were significantly higher in macroadenomas compared to microadenomas (p < .001). Medical treatment was administered as a second-line treatment (97%) in almost all patients without remission. Radiotherapy was preferred in 21% of the patients mostly as a third line treatment.

Conclusions

This is one of the largest real life studies evaluating the epidemiological characteristics and treatment outcomes of patients with acromegaly who were followed in different centers in Turkey. Transsphenoidal surgery in the treatment of acromegaly still remains the most valid method. Medical treatment options may improve long-term disease outcomes in patients who cannot be controlled with surgical treatment (up to 70%).



中文翻译:

土耳其十个不同中心的肢端肥大症登记处。

目标

描述土耳其肢端肥大症患者的生化和临床特征以及治疗结果。

方法

在土耳其肢端肥大症登记处的 10 个中心对 547 名患者进行了回顾性多中心流行病学研究。

结果

本研究共纳入了 547 名中位年龄为 41 岁的肢端肥大症患者(55% 为女性)。大多数患者患有大腺瘤 (78%)。92% 的患者 ( n  = 503) 将经蝶窦手术作为主要治疗。所有手术患者的手术缓解率为 39% (197/503)。70% 的患者实现了总体疾病控制。缓解组显着高于非缓解组 ( p  = .002)。微腺瘤患者的缓解率明显高于大腺瘤患者 ( p  < .001)。与大腺瘤患者相比,微腺瘤患者在诊断时明显年龄较大(p < .001)。缓解组的术前生长激素 (GH) 和胰岛素样生长因子 1 (IGF-1) 水平显着降低 ( p  < .001)。与微腺瘤相比,大腺瘤的初始 IGF-1 和 GH 水平显着更高(p < .001)。几乎所有没有缓解的患者都将药物治疗作为二线治疗(97%)。21% 的患者首选放疗,主要是作为三线治疗。

结论

这是评估在土耳其不同中心接受随访的肢端肥大症患者的流行病学特征和治疗结果的最大的现实生活研究之一。经蝶窦手术治疗肢端肥大症仍然是最有效的方法。对于无法通过手术治疗控制的患者(高达 70%),药物治疗选择可能会改善其长期疾病结果。

更新日期:2020-04-27
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