男性泌乳素腺瘤肿瘤生物学行为的研究进展

Research advances in the biological characteristics of male patients with prolactinoma

泌乳素腺瘤占所有垂体神经内分泌肿瘤的32%~66%,大多数泌乳素腺瘤属于良性肿瘤,且女性常见。然而,男性泌乳素腺瘤更具有进袭性,主要表现在术后反复复发、多巴胺激动剂耐药和放疗后肿瘤进展,以及更易发生垂体癌变。本文综述了近年来有关男性泌乳素腺瘤在肿瘤生物学特性方面的文献。文献表明,芳香化酶、SF3B1基因突变、E-钙黏蛋白/β-连环蛋白复合体受损、转化生长因子β1系统、特定基因和不稳定基因组的表达通过不同信号通路直接或间接导致男性泌乳素腺瘤在细胞增殖、上皮间充质转化、血管生成和对多巴胺激动剂抵抗等方面较女性泌乳素腺瘤具有独特的特征。未来还需要更多的研究进一步阐明男性泌乳素腺瘤进袭性的深层机制,将为有效的靶向治疗提供更全面、精准的理论依据。

Prolactinoma accounts for 32%-66%of pituitary neuroendocrine tumors and is a benign tumor in most cases,and it is com⁃monly seen in women.However,prolactinoma in men is more aggressive in clinical practice,manifesting as frequent recurrence after surgery,resistance to dopamine agonists,tumor progression after radiotherapy,and pituitary carcinogenesis.This article reviews the lit⁃erature on the biological characteristics of prolactinoma in male patients in recent years,and it is shown that compared with prolacti⁃noma in female patients,prolactinoma in male patients has unique characteristics in term of cell proliferation,epithelial-mesenchymal transition,angiogenesis,and resistance to dopamine agonist due to aromatase,SF3B1 gene mutation,disruption of E-cadherin/β-catenin complex,transforming growth factorβ1 system,and expression of specific genes and unstable genomes directly or indirectly through different signaling pathways.In the future,more studies are needed to further clarify the mechanism of the aggressiveness of prolactinoma in male patients and provide a more comprehensive and accurate theoretical basis for effective targeted therapy.