垂体腺瘤诊断和治疗现状

垂体腺瘤是一种比较特殊的颅内肿瘤，既有肿瘤的性质，同时也有内分泌学特性。垂体腺瘤的危害主要有：垂体激素过量分泌，产生一系列代谢紊乱和脏器损害；肿瘤压迫使其它垂体激素低下，引起相应的靶腺功能低下：肿瘤压迫鞍区结构，导致相应功能严重障碍。其诊断和治疗也应从以上三方面考虑。核磁共振检查及内分泌激素测定是垂体腺瘤诊断的重要手段。近些年来，越来越多的人们认识到经蝶入路优于经颅入路。本文从垂体腺瘤诊断和治疗方面需要明确的几个问题予以概述：垂体腺瘤的早期诊断和治疗，垂体腺瘤诊断和治疗的规范化，疗效的评价，侵袭性垂体腺瘤以及垂体腺瘤放疗应注意的几个方面。

Current Strategies of Diagnosis and Treatment for Pituitary Adenoma

Comparing with other intracranial tumors, pituitary adenomas are special tumors which not just neoplasm but usual also cause special endocrine symptoms at the same time. The major disturbances from these tumors could be summarized as following. First, the over-excretion of hormones may result in a series of metabolic disorders. Second, as a result of compression by tumor mass, the excretions of pituitary hormone could be insufficient resulting in deficiency of the target endocrine glands unavoidably. Moreover, certain serious disability such as vision loss may occur if the tumor is large. Such pathological mechanisms should be considered during the initial determination of the diagnosis and therapeutic strategies. The MRI and endocrine detections are the most useful methods for the diagnosis of pituitary adenoma. Recently, the advantages of transsphenoidal surgery have been acknowledged. Some critical points about how to diagnose and treat such tumor were reviewed in this article, which including early diagnosis and treatment, the standard of diagnosis and treatment, the evaluation of therapeutic effect, and about invasive pituitary adenoma as well as radiotherapy for pituitary adenoma.