无功能性垂体腺瘤卒中对术后残余瘤生长速率的影响  

Effect of nonfunctioning pituitary adenoma apoplexy on growth rate of residual tumor after operation

作　　者：吴志峰[1] 肖德勇[2] 王守森[2] 王如密[2] 

机构地区：[1]第二军医大学福州临床医学院神经外科,福州350025 [2]南京军区福州总医院神经外科,福州350025

出　　处：《中华神经医学杂志》2016年第10期1021-1025,共5页Chinese Journal of Neuromedicine

基　　金：（1）基金项目：南京军区“十二五”医学创新重点项目（20112034）（2）基金项目：福州总医院创新团队基金项目（2014-07）

摘　　要：目的探讨无功能性垂体腺瘤（NFPA）卒中对其术后残余瘤生长速率的影响。方法选择南京军区福州总医院神经外科自2005年5月至2015年5月行经鼻．蝶窦入路手术、且术后有肿瘤残余的57例NFPA患者，回顾性分析患者的MRI资料，计算残余瘤的肿瘤倍增时间（TVDT）、快速生长比、卒中囊变／肿瘤体积比，分析术后残余瘤的快速生长比与术前是否存在肿瘤卒中、腺瘤卒中病程及卒中囊变／肿瘤体积比的关系。结果30例NFPA患者出现腺瘤卒中，27例无腺瘤卒中；49例术后残余瘤的体积出现增大，8例萎缩，TVDT平均为（1305．82±1685．32）d。腺瘤卒中组与无腺瘤卒中组术后残余瘤的快速生长比分别为56．67％、66．67％，差异无统计学意义（P〉0．05）；亚急性腺瘤卒中组术后残余瘤的快速生长比为81．82％，显著高于慢性腺瘤卒中组（36．84％），差异有统计学意义（P〈0．05）；卒中囊变／肿瘤体积比〈12％组与≥12％组术后残余瘤的快速生长比分别为40．00％、66．67％，差异无统计学意义（P〉0．05）。结论肿瘤卒中是NFPA术后残余瘤生长速率的重要影响因素之一；对处于NFPA卒中亚急性、慢性期患者而言，若症状轻微，可以采用定期随访的策略。Objective To explore the effect of nonfunctioning pituitary adenoma （NFPA） apoplexy on growth rate of residual tumor after transsphenoidal operation. Methods The follow-up MR imaging data of 57 patients with NFPA who had residual tumors after transsphenoidal operation, admitted to our hospital from May 2005 to May 2015, were analyzed retrospectively. The tumor volume doubling time （TVDT） of residual tumors, rapid growth rate and apoplexy/tumor size ration were calculated. The relations of tumor rapid growth rate with existence of adenoma apoplexy, course of adenoma apoplexy and apoplexy/tumor size ration were compared. Results There were 30 patients with NFPA apoplexy and 27 without adenoma apoplexy. Postoperative follow-up indicated enlarged residual tumors in 49 patients, and shrank ones in 8 patients. The mean TVDT was （1305.82±1685.32） d. The rapid growth rate of residual tumors in NFPA apoplexy group （56.67%） was not significantly increased as compared with that in non- NFPA apoplexy group （66.67%,P〉0.05）. The rapid growth rate of subacute NFPA apoplexy group （81.82%） was significantly higher than that of chronic NFPA apoplexy group （36.84%, P〈0.05）. The rapid growth rate of group of apoplexy/tumor size ration less than 12% （40%） was not significantly different as compared with that of rapid growth rate of group of apoplexy/tumor size ration more than 12% （66.67%, P〉0.05）. Conclusions Adenoma apoplexy is one of the factors that affect the growth rate of residual tumors of NFPA after transsphenoidal operation. For patients with NFPA apoplexy in subacute or chronic phase, if their symptoms are mild, they can be followed up regularly.

关 键 词：无功能性垂体腺瘤 腺瘤卒中 生长速率 

分 类 号：R736.4[医药卫生—肿瘤]