Factors Affecting Hyperprolactinemia After Pituitary Surgery
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Factors Influencing Disconnection Hyperprolactinemia and Reversal of Serum Prolactin after Pituitary Surgery in a Non-Functioning Pituitary Macroadenoma
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Thinesh Kumran, Saffari Haspani, Jafri Malin Abdullah, Azmi Alias, Fan Rui Ven
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Factors Influencing Disconnection Hyperprolactinemia and Reversal of Serum Prolactin after Pituitary Surgery in a Non-Functioning Pituitary Macroadenoma
Year: 2016
Copyright (license): CC BY 4.0
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Summary of article contents:
Introduction
Pituitary adenomas are a common type of intracranial neoplasm, accounting for approximately 10% of such cases, with non-functioning adenomas being the most prevalent subset. These tumours can result in hyperprolactinemia, a condition typically induced by the stalk effect, where a compressed pituitary stalk reduces dopamine release, leading to increased prolactin secretion. This study aimed to explore the factors influencing disconnection hyperprolactinemia in patients with non-functioning pituitary macroadenomas, particularly focusing on tumour volume, pituitary stalk displacement, and subsequently measuring serum prolactin levels following surgical intervention.
Correlation Between Tumour Volume, Pituitary Stalk Angle, and Serum Prolactin Levels
The findings of this study revealed significant correlations among tumour volume, pituitary stalk angles, and serum prolactin levels. Pre-operative assessments showed a mean tumour volume of 10.58 cm³, which decreased to 3.1 cm³ post-surgery, marking a 70% reduction in size. Concurrently, mean serum prolactin levels diminished from 457 mIU/L pre-operatively to 297 mIU/L post-operatively, which represents a 65% reduction. The pituitary stalk angle also demonstrated a substantial decrease from 93.45 degrees to 51.45 degrees after surgery. Notably, a positive correlation was established between the tumour volumes and serum prolactin levels, as well as between serum prolactin levels and the pituitary stalk angle, showcasing the potential predictive value of tumour volume and stalk displacement on hyperprolactinemia.
Conclusion
This study substantiates the theoretical framework surrounding disconnection hyperprolactinemia, highlighting the influence of tumour volume and pituitary stalk angle on serum prolactin levels in non-functioning pituitary macroadenoma cases. The significant reductions in both serum prolactin levels and pituitary stalk angles following surgical resection suggest that surgical intervention can effectively restore hormonal balance in these patients. However, the authors advocate for larger sample sizes and further research to validate these findings thoroughly, thus enhancing our understanding of the underlying mechanisms and improving clinical outcomes for patients with such conditions.
FAQ section (important questions/answers):
What is the objective of the study on hyperprolactinemia?
The study aimed to investigate factors influencing disconnection hyperprolactinemia in non-functioning pituitary macroadenoma, including tumour volume, pituitary stalk displacement, and to confirm reductions in serum prolactin levels following endoscopic transphenoidal surgery.
How many patients were involved in the study?
Forty patients who met the inclusion criteria participated in the study, which was conducted at the Department of Neurosurgery, General Hospital Kuala Lumpur from January 1, 2011, to January 1, 2013.
What significant results were found post-surgery regarding serum prolactin levels?
Post-operatively, serum prolactin levels decreased by an average of 65%, reducing from 457 mIU/L pre-operatively to 297 mIU/L, showing a statistically significant change of P < 0.01.
What conclusions can be drawn about tumour volume and stalk angle?
The study concluded that both tumour volume and pituitary stalk angle displacement have positive predictive values for disconnection hyperprolactinemia in non-functioning pituitary macroadenoma, indicating a correlation with serum prolactin levels.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Factors Affecting Hyperprolactinemia After Pituitary Surgery”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Post:
In a medical context, 'Post' frequently refers to the postoperative period, where the patient has undergone surgery. It is during this time that researchers look at the outcomes and effects of the surgical procedure, including changes in hormone levels, tumor volume, and overall patient recovery and monitoring for complications.
2) Table:
A 'Table' in research is a visual representation of data, summarizing statistics and findings for clarity and ease of understanding. In the context of the study, it would display key measurements such as serum prolactin levels or tumor volumes pre and post-surgery, aiding in drawing quick comparisons and conclusions.
3) Study (Studying):
'Study' refers to the systematic investigation within the medical field, aimed at understanding specific phenomena or patient conditions. In this context, it pertains to the examination of non-functioning pituitary macroadenomas, their effects on prolactin levels, and correlating factors, contributing significantly to knowledge in endocrine disorders.
4) Line:
'Line' often represents a boundary or connection between concepts or measurements in research. In this study, it can refer to angles drawn to measure the pituitary stalk's position in MRI imaging. Accurate measurements are crucial for assessing the tumor's impact and predicting postoperative recovery and hormonal response.
5) Gold (Golden):
'Gold' in research could refer to a standard or benchmark, often seen in phrases like 'gold standard'. This standard represents the most reliable method for diagnosing or treating a condition. In this study's context, recognizing the best practices for surgery on pituitary adenomas could improve patient outcomes.
6) Blood:
'Blood' is essential in medical research, specifically for its role in indicating health status through hormonal levels, such as prolactin. Measurements of serum prolactin levels pre- and post-surgery provide critical insights into the effectiveness of the intervention and the overall health of the endocrine system post-operation.
7) Field:
'Field' might refer to both a medical specialty and the domain of inquiry in research. In this study, the 'field' encompasses neurosurgery and endocrinology, focusing on pituitary disorders, where understanding the interaction between tumor presence and hormone regulation is critical for diagnosis and treatment strategies.
8) Male:
'Male' is a demographic descriptor commonly used in research to indicate gender differences in medical conditions. In the study, a slight male predominance among patients may have implications for the understanding of pituitary macroadenomas, hormone secretion patterns, and potential variations in treatment response and outcomes.
9) Measurement:
'Measurement' is a fundamental aspect of research, involving the quantification of variables essential for analysis. The study employs various measurements, including tumor volume and serum prolactin levels, to evaluate the effects of surgery comprehensively. Accurate measurement ensures reliable results and aids in subsequent patient management decisions.
10) Discussion:
'Discussion' in a research context is a critical section where findings are interpreted in relation to existing literature and clinical implications. This study's discussion would explore the outcomes of surgical intervention on prolactin levels and the correlation with tumor characteristics, fostering a deeper understanding of pituitary disorders.
11) Substance:
'Substance' often refers to chemical or biological materials relevant in medical research, such as hormones or drugs. In this study, understanding the substances involved—like prolactin—links directly to the physiological changes observed post-surgery. Exploring these substances contributes to a broader understanding of endocrine functions and disorders.
12) Account:
'Account' in research often refers to a narrative or description of findings or observations. It may involve detailing patient outcomes or case studies, providing valuable insights into the conditions affecting hormone levels and tumor behavior. This aids in understanding individual patient experiences in the larger context of disease management.
13) Rules:
'Rules' encompasses guidelines or established protocols governing research methods or clinical practices. In the context of the study, rules could refer to criteria for patient inclusion in the research or protocols for measuring outcomes. Adherence to these rules ensures rigorous scientific methods and enhances the validity of the results.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Factors Affecting Hyperprolactinemia After Pituitary Surgery’. Further sources in the context of Science might help you critically compare this page with similair documents:
Control group, Healthy individual, Pre operative, Post operative, Visual field defect, Statistical analyses, Magnetic resonance imaging, Hypopituitarism, Clinical correlation, Hyperprolactinemia, Pituitary macroadenoma, Prospective descriptive study, Tumour volume, Pituitary adenoma, Pre-operative measurements, Serum prolactin level.