OBJECTIVE Data on pre- and postoperative pituitary function in nonfunctioning pituitary adenomas (NFPA) are not consistent. We aimed to investigate pituitary function before and up to 5 years after transsphenoidal surgery with emphasis on the hypothalamic-pituitary-adrenal axis (HPA). DESIGN AND METHODS Data from the Swedish Pituitary Register was used to analyze anterior pituitary function in 838 patients with NFPA diagnosed between 1991 and 2014. Patients who were reoperated or had received radiotherapy were excluded. RESULTS Preoperative ACTH, TSH, LH/FSH, and GH deficiencies were reported in 31% (236/755), 39% (300/769), 51% (378/742), and 28% (170/604) of the patients, respectively. Preoperative median tumor volume was 5.0 (2.4-9.0) cm3. Among patients with preoperative, 1 year and 5 years postoperative data on the HPA axis (n = 428), 125 (29%) were ACTH-deficient preoperatively. One year postoperatively, 26% (32/125) of them had recovered ACTH function while 23% (70/303) patients had developed new ACTH deficiency. Thus, 1 year postoperatively, 163 (38%) patients were ACTH-deficient (P < .001 vs. preoperatively). No further increase was seen 5 years postoperatively (36%, P = .096). At 1 year postoperatively, recoveries in the TSH and LH/FSH axes were reported in 14% (33/241) and 15% (46/310), respectively, and new deficiencies in 22% (88/403) and 29% (83/288), respectively. CONCLUSIONS Adrenocorticotrophic hormone deficiency increased significantly at 1 year postoperatively. Even though not significant, some patients recovered from or developed new deficiency between 1 and 5 years postoperatively. This pattern was seen in all axes. Our study emphasizes that continuous individual evaluations are needed during longer follow-up of patients operated for NFPA.

中文翻译：

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无功能垂体腺瘤手术前后的垂体功能 - 数据来自瑞典垂体登记处。

目的 无功能性垂体腺瘤 (NFPA) 术前和术后垂体功能的数据并不一致。我们的目的是调查经蝶手术前和术后 5 年内的垂体功能，重点关注下丘脑-垂体-肾上腺轴 (HPA)。设计和方法 使用瑞典垂体登记处的数据分析 1991 年至 2014 年间诊断的 838 名 NFPA 患者的垂体前叶功能。再次手术或接受放疗的患者被排除在外。结果 31% (236/755)、39% (300/769)、51% (378/742) 和 28% (170/604) 的患者术前 ACTH、TSH、LH/FSH 和 GH 缺乏。分别为患者。术前肿瘤体积中位数为 5.0 (2.4-9.0) cm3。在具有术前、术后 1 年和术后 5 年 HPA 轴数据的患者 (n = 428) 中，125 例 (29%) 术前存在 ACTH 缺陷。术后一年，26% (32/125) 的患者恢复了 ACTH 功能，而 23% (70/303) 的患者出现了新的 ACTH 缺乏。因此，术后 1 年，163 名 (38%) 患者存在 ACTH 缺乏（与术前相比，P < 0.001）。术后 5 年未见进一步增加 (36%, P = .096)。术后 1 年，TSH 和 LH/FSH 轴恢复的比例分别为 14% (33/241) 和 15% (46/310)，新的缺陷分别为 22% (88/403) 和 29% ( 83/288），分别。结论 术后 1 年促肾上腺皮质激素缺乏症显着增加。尽管不显着，但一些患者在术后 1 至 5 年内恢复或出现新的缺陷。在所有轴上都可以看到这种模式。我们的研究强调，在对接受 NFPA 手术的患者进行较长时间的随访期间，需要进行持续的个体评估。