影响垂体生长激素腺瘤经蝶手术疗效的因素分析  

Analysis of factors influencing effect of transsphenoidal microsurgery for growth hormone-secreting pituitary adenoma

作　　者：毛志钢[1] 王海军[2] 何东升[2] 徐伟光[2] 冯雷[2] 

机构地区：[1]番禺区人民医院神经外科,广东广州511400 [2]中山大学附属第一医院神经外科,广东广州510080

出　　处：《中国微侵袭神经外科杂志》2006年第4期151-153,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：国家自然科学基金项目(30470597);广东省自然科学基金项目(04009358)

摘　　要：目的评价垂体生长激素腺瘤经蝶手术的疗效和分析影响手术疗效的相关因素。方法回顾性分析62例资料完整经蝶手术治疗的垂体生长激素腺瘤病人的临床资料,根椐肿瘤大小、术前生长激素水平、侵袭性、肿瘤病理类型等进行分类。按肢端肥大症的治愈标准,采用术后激素水平结合影像学复查评价手术疗效。结果总缓解率为66.1%,微腺瘤、大微腺、巨大腺瘤术后缓解率分别为87.5%、71.8%和40.0%,侵袭性和非侵袭性腺瘤则为36.8%和79.7%。微腺瘤与巨大腺瘤(P<0.05)、侵袭性与非侵袭性腺瘤术后缓解率有统计学差异(P<0.001)。结论微腺瘤和非侵袭性大腺瘤采用经蝶手术可取得满意疗效,侵袭性腺瘤或巨大腺瘤采用经蝶手术治愈率较低。Objective To evaluate the therapeutic effect of transsphenoidal microsurgery for growth hormone-secreting pituitary adenoma （GHPA） and analyze the correlative factors influencing the effect. Methods The clinical data of 62 patients who underwent transsphenoidal microsurgery for GHPA were retrospectively analyzed. The tumors were classified according to tumor size, preoperative GH levels, invasion, and pathological type etc. Based on the criterion of cure of acromegaly, postoperative hormone level and imaging examination were used to evaluate the post-operative outcomes. Results Total remission rate was 66.1%, and the post-operative remission rates of microadenomas, macroadenomas and giant adenomas （〉40 mm） were 87.5%, 71.8% and 40.0% respectively. There was statistical significance in difference of the remission rate between microadenomas and giant adenomas （P 〈 0.05）. The remission rates ofinvasive adenomas and noninvasive adenomas were 36,8% and 79.7% respectively, showing significant difference between them （P 〈 0.001）. Conclusion The therapeutic effects of transsphenoidal surgery for acromegalic patients with microadenomas and noninvasive big pituitary adenomas were satisfactory, while the invasive adenomas and giant adenomas had poor prognosis.

关 键 词：垂体肿瘤 肢端肥大症 经蝶手术 生长激素 胰岛素类生长因子Ⅰ 

分 类 号：R736.4[医药卫生—肿瘤]