无功能性垂体腺瘤（NFPA）的术前和术后垂体功能数据不一致。我们旨在调查经经蝶鞍手术治疗前和治疗后最长五年的垂体功能，重点关注下丘脑-垂体-肾上腺皮质（HPA）轴。我们使用了瑞典垂体瘤登记处的数据来分析1991年至2014年间838名NFPA患者的前垂体功能。被重新手术或接受放射治疗的患者被排除。术前ACTH、TSH、LH / FSH和GH缺乏分别报告在患者中的31％（236/755）、39％（300/769）、51％（378/742）和28％（170/604）。术前中位肿瘤体积为5.0（2.4-9.0）cm3。在具有术前、一年和五年术后HPA轴数据的428名患者中，125名（29％）在术前缺乏ACTH。术后一年，其中32名（32/125）已恢复ACTH功能，而303名患者中有70名（23％）新出现ACTH缺陷。因此，术后一年，163名（38％）患者缺乏ACTH（P <0.001与术前相比）。术后五年未看到进一步增加（36％，P = 0.096）。术后一年甲状腺刺激素和LH / FSH轴的恢复分别为241名患者中的14％（33/241）和310名患者中的15％（46/310），新缺陷分别为403名患者中的22％（88/403）和288名患者中的29％（83/288）。术后一年ACTH缺乏明显增加。虽然不显着，但一到五年术后一些患者恢复或新出现了缺陷。这种模式在所有轴中都可见。我们的研究强调了在NFPA手术患者的长期随访中需要进行持续的个体评估。©2023 作者。由牛津大学出版社代表欧洲内分泌学会出版。

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 five years after transsphenoidal surgery with emphasis on the hypothalamic-pituitary-adrenal axis (HPA).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.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. Amongst patients with preoperative, one year and five 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, one year postoperatively 163 (38%) patients were ACTH-deficient (P <0.001 vs. preoperatively). No further increase was seen five years postoperatively (36%, P=0.096). At one 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.ACTH deficiency increased significantly at one year postoperatively. Event though not significant, some patients recovered from or developed new deficiency between one and five 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.© The Author(s) 2023. Published by Oxford University Press on behalf of European Society of Endocrinology.