垂体多激素腺瘤的免疫病理研究

目的 探讨垂体多激素腺瘤的临床表现和免疫病理学特点，以提高其病理诊断的准确性。方法 选取1990年3月至2002年12月经手术切除的垂体多激素腺瘤103例进行免疫组化检测，其中18例另行双标记免疫组化染色。结果 全组以PRL-GH型垂体腺瘤最多，共10例（9．7％）。大多数病例只表现出一种内分泌症状，仅7例（6．8％）表现出两种不同的内分泌症状。垂体多激素腺瘤的免疫组化组合形式多样，2～6种激素组合均有。免疫组化、血清激素水平与内分泌症状之间相关性最好的激素是PRL。结论垂体多激素腺瘤的免疫组化检测对于其正确的病理诊断非常重要。

Immunopathologicai Study of Plurihormonal Pituitary Adenomas

Objective To study the clinical and immunopathological characteristics of plurihormonal pituitary adenomas for improving the accuracy of the pathological diagnosis. Methods The studied material included 103 specimen of plurihormonal pituitary adenomas which were removed by surgery March, 1990 to December, 2002. Immunohistochemical study was performed in all the adenomas and serum hormonal levels were determined in all the patients with pituitary adenomas. Double-labeling immunohisto-chemical staining of all the possible combinations of the hormones was performed in 18 cases of the selected pituitary adenomas. Results Mixed GH-PRL adenomas were most ones in all the plurihonnonal pituitary adenomas and accounted for 9.7% （10/103） of plurihormonal pituitary adenomas. There were symptoms only related to one of the hormones in most of the patients with plurihormonal pituitary adenomas and symptoms related to two hormones in 7 of 103 （6.8%） patients with plurihormonal pituitary adenomas. There were various kinds of pituitary hormones in each of all the adenomas. The correlation among outcome of immunohistochemical staining, serum hormonal levels and symptoms related to hormone was the closest in the patients with PRL adenomas. Conclusion Immuno- histochemical staining of all the pituitary hormones is mandatory for correct pathological diagnosis of plurihormonal pituitary adenomas and helpful tO the study of the histogenesis of pituitary adenomas.