神经内镜手术治疗垂体生长激素腺瘤术后生化缓解相关因素分析  

Analysis of risk factors related tobiochemical remission of patients with growth hormone-secreting pituitary adenomas treated by the endoscopic endonasal surgery

作　　者：陆岳 晁晓峰 张奇 苗发安 范月超 LU Yue;CHAO Xiaofeng;ZHANG Qi;MIAO Faan;FAN Yuechao(Department of Neurosuigery,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院神经外科,江苏徐州221000

出　　处：《中国肿瘤外科杂志》2023年第2期149-152,157,共5页Chinese Journal of Surgical Oncology

摘　　要：目的研究神经内镜下经鼻蝶入路治疗垂体生长激素(GH)腺瘤术后生化缓解的影响因素。方法回顾性分析2017年3月至2022年6月徐州医科大学附属医院采用神经内镜经鼻蝶治疗的90例垂体GH腺瘤患者的临床资料,术后根据2021版《中国肢端肥大症诊治共识》中的生化缓解标准判断患者是否达到生化缓解,并将其分为生化缓解组(47例)和生化未缓解组(43例),采用单因素分析两组患者的临床资料,并采用多因素Logistic回归分析术后生化缓解的危险因素。结果90例接受神经内镜治疗的垂体GH腺瘤患者中,47例患者达到生化缓解,术后生化缓解率为52.2%;与生化未缓解组相比,生化缓解组患者的术前GH水平以及巨大肿瘤、Knosp分级3~4级、肿瘤包绕颈内动脉角度≥135°患者比例低于生化未缓解组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,术前高GH水平及肿瘤包绕颈内动脉角度≥135°是影响术后生化缓解的独立危险因素。结论术前GH水平较低、肿瘤包绕颈内动脉角度较小的患者术后更容易获得生化缓解。Objective To investigate the risk factors of the biochemical remission of patients with growth hormone(GH)-secreting pituitary adenomas treated by the endoscopic endonasal surgery.Methods A retrospective clinical data was conducted on 90 patients with GH-secreting pituitary adenomas underwent endoscopic endonasal surgery in our hospital from March 2017 to June 2022.According to the 2021 biochemical criteria,they were divided into biochemical remission group(n=47)and non-remission group(n=43).The data was analyzed by single factor analysis.Multivariate logistic regression analysis was performed to analyze the independent related factors.Results There were 52.2%(47/90)patients achieving biochemical remission.There were statistically significant differences in preoperative GH value,tumer size,Knosp Grade 3-4 and value tumor surrounding angle of internal carotid artery(≥135°)between the patients with and without biochemical remission(P<0.05).Multivariate logistic regression analysis showed that higher preoperative GH and value tumor surrounding angle of internal carotid artery(≥135°)were related factors.Conclusions Biochemical remission was more likely in patients with lower preoperative GH or value tumor surrounding angle of internal carotid artery<135°.

关 键 词：神经内镜 垂体生长激素腺瘤 生长激素 生化缓解 影响因素 

分 类 号：R736.4[医药卫生—肿瘤]