Comparative study on the characteristics of neuroendocrine dysfunction in children and adolescents with craniopharyngioma
10.3760/cma.j.issn.1000-6699.2016.07.010
- VernacularTitle:儿童与青少年期颅咽管瘤患者神经内分泌功能受损特点比较研究
- Author:
Ying GUO
;
Liyong ZHONG
- Publication Type:Journal Article
- Keywords:
Craniopharygioma;
The mass effects in situ;
Neuroendocrine function;
Child;
Puberty
- From:
Chinese Journal of Endocrinology and Metabolism
2016;32(7):579-583
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the impact of the mass effects in situ ( MEIS ) of the sella tumor on neuroendocrine function in children and adolescents with craniopharyngioma before surgery. Methods A total of 227 inpatients with craniopharyngioma in Beijing Tiantan Hospital, Capital Medical University, from October 2009 to October 2014, were retrospectively analyzed. These patients were divided into children group ( n = 167 ) and adolescent group(n=60) according to the age at the time of the first diagnosis. The clinical characteristics and damage degrees of neuroendocrine function by MEIS of sella tumor were analyzed and compared between these two groups before surgery. Result (1) Clinical characteristics of neuroendocrine function:Among hypothalamic dysfunctional manifestations, central diabetes insipidus showed the highest percentage(children group 35. 93%vs adolescent group 31. 67%), followed by the abnormal appetite and obesity ( children group 19. 76% vs adolescent group 28. 33%). The incidences of abnormal body temperature regulation, sleeping disorder, personality abnormality, and cognitive abnormality all were less than 5%. There were no statistical significant differences in the aforementioned hypothalamic dysfunction parameters between two groups (P=0. 524). Among pituitary-target glands dysfunction parameters, growth hormonce ( GH )-insulin-insulin like growth factor Ⅰ( IGF-Ⅰ) axis dysfunction showed the highest percentage ( children group 64. 07% vs adolescent group 50. 0%), followed by pituitary-gonad axis dysfunction in adolescent group (53. 33%), hyperprolactinemia ( children group 31. 14% vs adolescent group 43. 33%), pituitary-thyroid dysfunction(children group 22. 16%vs adolescent group 28. 33%), pituitary-adrenal gland dysfunction(children group 20. 36%vs adolescent group 25%). There were no statistical significant differences intheseabnormalpituitary-targetglandaxes(exceptpituitary-gonadaxis)betweentwogroups(P=0.475). (2) Comparison of damage degrees of neuroendocrine dysfunction: The patients with normal neuroendocrine function accounted for 10. 2%in children group and 8. 3%in adolescent group. The patients with 1 to 4 items of neuroendocrine dysfunction accounted for 75. 6%in children group and 73. 3%in adolescent group. The patients with more than 5 items of neuroendocrine dysfunction accounted for 14. 4%in children group and 18. 4%in adolescent group. There were no significant differences between two groups(Z=-1. 63,P=0. 103). Conclusions There were no significant differences in characteristics and damage degrees of MEIS of the sella tumor on neuroendocrine dysfunction between children and adolescents with craniopharyngioma. It suggests that systematical evaluation on hypothalamus-pituitary-targets axis function is very important for reducing the risks of further neuroendocrine dysfunction in young patients with craniopharyngioma after surgery.