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4 . 2022

Prognosis of long-term results of surgical and drug treatment of patients with acromegaly syndrome

Abstract

This review discusses the problems of predicting long-term results of surgical and drug treatment of patients with acromegaly, taking into account multiple pathomorphological variants of somatotrophic adenomas. It was noted that rarely granular somatotrophic adenomas are characterized by large size, extrasellar and invasive growth, negative surgical prognosis and resistance to 1st generation somatostatin analogues (SA1). On the contrary, densely granular adenomas are characterized by a benign course, small size, high percentage of radical removal and good sensitivity to SA1. Among the differential diagnostic predictors, there are: peculiarities of tumor development, the nature of receptor expression, the value of the Ki‑67 index, the intensity of the signal on T2-weighted MR-images, the effectiveness of short-term therapy of SA1, etc. Further improvement of diagnostic and prognostic models based on clinical and morphological comparison will make it possible to implement a strategy of precision and personalized approach to the treatment of patients with acromegaly syndrome.

Keywords:acromegaly; somatotrophic pituitary adenomas; laboratory and instrumental diagnostics; predictors of the effectiveness of surgical and drug treatment; somatostatin analogues

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Pronin V.S., Antsiferov M.B., Alekseeva T.M., Pronin E.V. Prognosis of long-term results of surgical and drug treatment of patients with acromegaly syndrome. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2022; 11 (4): 48–59. DOI: https://doi.org/10.33029/2304-9529-2022-11-4-48-59 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
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