Several subtypes of pituitary neuroendocrine tumors (PitNETs), such as acromegaly and Cushing’s disease, can result in hypertension. However, whether prolactinoma is associated with this complication remains unknown. Moreover, the effect of treatment with surgery or drugs on blood pressure (BP) is unknown. Herein, a retrospective study reviewed 162 patients with prolactinoma who underwent transsphenoidal surgery between January 2005 and December 2022. BP measurements were performed 1 day before and 5 days after surgery. Accordingly, patients’ medical characteristics were recorded. In addition, in situ rat and xenograft nude-mice prolactinoma models have been used to mimic prolactinoma. In vivo BP and serum prolactin (PRL) levels were measured after cabergoline (CAB) administration in both rats and mice. Our data suggest that surgery can effectively decrease BP in prolactinoma patients with or without hypertension. The BP-lowering effect was significantly associated with several variables, including age, sex, disease duration, tumor size, invasion, dopamine agonists (DAs)-resistance, recurrence, and preoperative PRL levels. Moreover, in situ and xenograft prolactinomas induced BP elevation, which was alleviated by CAB treatment without and with a statistical difference in rats and mice, respectively. Thus, surgery or CAB can decrease BP in prolactinoma, indicating that pre- and postoperative BP management becomes essential.
垂体神经内分泌肿瘤（PitNETs）的若干亚型，如肢端肥大症与库欣病，可导致高血压。然而，催乳素瘤是否与此并发症相关尚不明确。此外，手术或药物治疗对血压（BP）的影响亦未可知。本研究通过回顾性分析，纳入了2005年1月至2022年12月期间接受经蝶窦手术的162例催乳素瘤患者。血压测量于术前1天及术后5天进行，并相应记录患者的临床特征。同时，研究采用原位大鼠模型及异种移植裸鼠催乳素瘤模型模拟疾病状态。在大鼠与小鼠中，均于卡麦角林（CAB）给药后检测其体内血压及血清催乳素（PRL）水平。数据显示，手术能有效降低催乳素瘤患者（无论是否伴有高血压）的血压。该降压效果与年龄、性别、病程、肿瘤大小、侵袭性、多巴胺激动剂（DAs）耐药性、复发情况及术前PRL水平等多个变量显著相关。此外，原位及异种移植催乳素瘤模型均诱发血压升高，而CAB治疗可缓解此现象——在大鼠与小鼠模型中，该缓解作用分别呈现无统计学差异及有统计学差异。因此，手术或CAB治疗均可降低催乳素瘤患者的血压，这表明围手术期血压管理至关重要。
Alternations of Blood Pressure Following Surgical or Drug Therapy for Prolactinomas
肿瘤(癌症)患者之家