垂体生长激素腺瘤的临床和病理特征  

Clinical and pathological characteristics of patients with growth hormone-secreting pituitary adenomas

作　　者：陈晓[1] 何新尧[1] 陈宇凡[1] 赵卫国[1] 孙青芳[1] 卞留贯[1] 王卫庆[2] 宁光[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院神经外科,上海200025 [2]上海交通大学医学院附属瑞金医院内分泌代谢病临床医学中心,上海200025

出　　处：《中国临床神经外科杂志》2013年第8期458-460,共3页Chinese Journal of Clinical Neurosurgery

基　　金：国家自然科学基金(81270856)

摘　　要：目的探讨垂体生长激素(GH)腺瘤患者的临床及病理学特征。方法回顾性分析92例垂体GH腺瘤患者的临床资料,均采用经鼻蝶手术治疗。结果本组患者均有典型肢端肥大症状,但只有20例出现其他内分泌症状;共有微腺瘤20例,大腺瘤72例;侵袭性腺瘤19例,非侵袭性73例;术后免疫组织病理学结果示,GH(+)15例,GH(+)和泌乳素(+)38例,GH(+)和促肾上腺皮质激素(+)2例,GH(+)和促卵泡激素(+)1例,GH(+)和促黄体激素(+)1例;包括GH在内的三种及以上激素(+)35例。术后1周总缓解率为55.4%(51/92)。单纯GH(+)腺瘤缓解率为66.7%(10/15),伴其它激素阳性腺瘤缓解率为53.2%(41/77),两者无统计学差异(P>0.05)。73例患者术后随访3～52个月,平均30.3个月,肢端肥大症状、月经不调、溢乳、性欲减退和甲状腺功能异常缓解率分别为86.3%(63/73)、71.4%(5/7)、66.7%(4/6)、33.3%(2/6)和42.9%(3/7)。结论多数垂体GH腺瘤组织病理学表现为多激素阳性腺瘤,但是仅有少数患者表现出除肢端肥大症外的其它内分泌症状。Objective To analyze the clinical and pathological characteristics of growth hormone （GH）-secreting pituitary adenomas. Methods The clinical and pathological data of 92 patients with GH-secreting pituitary adenomas, who underwent microsurgery from January, 2000 to July, 2012, were analyzed retrospectively. Results Of 92 GH-secreting pituitary adenomas, the pathological findings showed that 20 were microadenoma （~〈 10 mm in size） and 72 macroadenoma （〉10 mm in size）; 19 were invasive adenomas and 73 non-invasive; 15 were GH-positive adenomas and 77 GH-positive and other hormones positive （38 were GH- and prolactin-positive）. All patients presented with acromegaly, but only 20 patients （21.7%） presented with other endocrinolgieal symptoms besides acromegaly. The overall rate of postoperative symptom relief was 55.4% （51/92） one week after operation, and there were no significant differences between the patients with GH-positive pituitary adenomas （66.7%, 10/15） and the patients with GH-positive and other hormone positive （53.2%, 41/77; P〉0.05）. Seventy-three patients were followed up for 3~52 months （mean, 30.3 months） and the outcomes showed that no patient died, and the remission rates of acromegaly, irregular menses, galactorrhea, hypaphrodisia and abnormal thyroid function were 86.3% （63/73）, 71.4% （5/7）, 66.7% （6/7）, 33.3% （2/6） and 42.9% （3/7）, respectively. Conclusions Most GH-secreting pituitary adenomas are GH positive and other hormone positive adenomas and the most common type is GH- and prolactin-positive adenomas. But only a few of adult patients with GH-secreting pituitary adenomas present with other endocrinolgieal symptoms besides acromegaly.

关 键 词：垂体生长激素腺瘤 临床特征 病理学特征 

分 类 号：R739.41[医药卫生—肿瘤]