Follow-up And Analysis Of Prolacatinomas After Bromocriptine Treatment

Objective:To assess the clinical effects of bromocriptine treatmentMethods: From november 2007 to March 2009, in the Central South University Xianya Hospital neurosurgery Pituitary adenoma studies group out-patient service time, clinical diagnosis of pituitary prolactin tumor and follow-up 3 months at least, simply taking Bromocriptine treatment of 37 cases were retrospectively analyzed. Male 2,Female 35,F:M=17.5:1. Maximum age 54 years old,the youngest 13 years old,average 29.95±8.89.Follow-up 108-1921 days,median 400 days. Track record of patient information in clinical symptoms,signs,hormone levels,imaging studies,including before and after treatment changes in symptoms,prolactin levels and tumor volume ,which access the effectiveness of drug treatment.Results: 37 cases of drug treatment patients,the total effective rate of 36 cases (36/37, 97.3%) , ineffective in 1 case(2.7%),no deaths and no serious complications. Gender simply efficient treatment:Male, agile effective 0 case(0%),effective 2 cases(2/2,100%),no obvious 0 case(0%),invalid 0 case(0%);women,agile effective 11 cases(11/35, 31.4%),effective 22 cases(22/35,62.9%),no obvious 1 case(l/35,2.85%), invalid 1 case(1/35.2.85%).Invasive tumors 22 cases (22/37,59.46%): microadenoma(4/22,18.18%),agile effective 2 cases,effective 2 cases; large adenomas 17 cases(17/22,77.27%),agile effective 7 cases,effective 9 cases,invalid 1 case;giant adenoma 1 case(l/22,4.55%),effective 1 case;non-invasive tunors 15 cases (15/37,40.54%).microadenoma 9 cases(9/15,60.0%),agile effective lcase,effective 7 cases,no obvious 1 case;large adenomas 6 cases(6/15,40.0%).agile effective 1 case,effective 5 cases. Efficacy and biological behavior of tumors with U test P=0.098( > 0.05),no statistical significance;efficacy and tumor size non-parametric test P=0.958(>0.05),no statistical significance;prolactin levels and efficacy non-parametric test P=0.763(>0.05) no statistical significance. After drug treatment menstral disorders improvement rate 72.72%(p<0.05, have statistical signigicance),amenorrhea improvement rate 94.12% p<0.05, have statistical signigicance),lactation improvement rate 76.9%(p < 0.05, have statistical signigicance).Spearman rank correlation analysis and regression equation of PRL levels before drug treatment and tumor volume show F=37.737 P=0.000;Spearman rank correlation of PRL levels after drug treatment and tumor volume show R=0.045 P=0.742. Conclusions1. 37 cases of this group of cases,patients require continuous drug treatment,or prolactin and/or tumor volume have a rebound. Bromocreptine treatment of prolactin tumor alone is a comprehensive treatment program in a way.2.PRL level were positively correlated with the largest tumor diameter before bromocriptine treatment,but after bromocriptine treatment this relationship no longer exist.3.Bromocriptine doses have no relationship with bromocriptine treatment efficiency and the level of PRL before drug treatment.4. Bromocriptine doses have no relationship with bromocriptine treatment efficiency and the largest tumor diameter pre-medacation.5.Bromocriptine treatment of prolactin tumor effect of individual is differences,and should be started at small doses and track changes in PRL and tumor volume,then we change drug doses adjustment.