胃癌患者血清中可溶性CD44v6含量和组织中CD44v6蛋白表达的研究

目的:研究胃癌患者外周血清中可溶性CD44v6(sCD44v6)含量/CD44v6蛋白表达,及其与临床病理参数之间的关系。方法:应用定量ELISA方法检测胃癌患者(术前和术后)及健康对照组血清中sCD44v6含量,并以(S-P)免疫组化法测定相应组织中CD44v6蛋白的表达。结果:70例胃癌患者血清中sCD44v6含量(2.15±0.78 ng/ml)明显高于16例正常对照组(1.18±0.43 ng/ml),14树根治性手术后血清中sCD44v6含量(1.21±0.39 ng/ml)比术前(2.67±0.83 ng/ml)明显下降(P<0.01),而6例非根治性手术后(3.29±0.41ng/ml)比术前(3.61+0.49 ng/ml)下降不明显(P>0.05)。而胃癌组织中CD44v6蛋白表达在肠型和弥漫型中有显著差异,不同的浸润深度、有无淋巴结及远处转移也有显著差异。结论:胃癌患者外周血清中sCD44v6含量及组织中CD44v6蛋白表达的变化与转移、临床分期、病理分期有关,sCD44v6含量升高可作为胃癌患者淋巴结转移(尤其是早期转移)的监测指标。     

胃癌患者血清中可溶性黏附分子CD44v6含量和组织中CD44v6蛋白表达的研究

目的:研究胃癌患者外周血清中可溶性黏附分子sCD44v6含量/CD44v6蛋白表达,及其与临床病理参数之间的关系。方法:应用定量酶联免疫吸附试验(ELISA)方法检测胃癌患者(术前和术后)及健康对照组血清中sCD44v6含量,并以免疫组化S-P法测定相应组织中CD44v6蛋白的表达。结果:70例胃癌患者血清中sCD44v6含量(2.15±0.78)ng/ml,明显高于16例正常对照组(1.18±0.43)ng/ml;14例根治性手术后血清中sCD44v6含量(1.21±0.39)ng/ml,比术前(2.67±0.83)ng/m明显下降(P<0.01);而6例非根治性手术后(3.29±0.41)ng/ml比术前(3.61±0.49)ng/ml下降不明显(P>0.05)。而胃癌组织中CD44v6蛋白表达在肠型和弥漫型中差异显著,不同的浸润深度、有无淋巴结及远处转移也差异显著。结论:胃癌患者外周血清中sCD44v6含量及组织中CD44v6蛋白表达的变化与转移、临床分期、病理分期有关,sCD44v6含量升高可作为胃癌患者淋巴结转移,尤其是早期转移的监测指标。     

可溶性CD44v6、VEGF检测在结核性腹水和卵巢癌性腹水鉴别诊断中的价值

目的探讨可溶性CD44变异性外量子(sCD44v6)及血管内皮生长因子(VEGF)对结核性、卵巢癌性腹水的诊断价值。方法选取39例卵巢癌性腹水、48例结核性腹水采用酶联免疫吸附试验(ELISA)检测腹水中sCD44v6及VEGF的水平,并进行相关性分析。结果卵巢癌性腹水组sCD44v6水平为(102±31)ng/ml,明显高于结核性腹水组(44±15)ng/ml,差异有统计学意义(P<0.01)。卵巢癌性腹水组VEGF水平为(684±210)ng/ml,明显高于结核性腹水组(90±11)ng/ml,差异有统计学意义(P<0.01)。sCD44v6以>60.5 ng/ml为阳性界值,sCD44v6诊断卵巢癌性腹水的敏感性为82.1%(32/39),特异性为87.5%(42/48);VEGF以>101.3 ng/ml为阳性界值,VEGF诊断卵巢癌性腹水的敏感性为92.3%(36/39),特异性为89.9%(43/48)。结论癌性腹水中的CD44v6、VEGF水平明显升高,sCD44v6、VEGF的检测对于结核性、卵巢癌性腹水的鉴别诊断有重要价值。     

CD44在垂体腺瘤中的表达及其临床意义

目的:研究垂体腺瘤(pituitaryadenoma)中细胞粘附分子(CD44)的表达,探讨CD44对垂体腺瘤诊断及预后意义。方法:用免疫组化(SP)的方法检测 20例侵袭性垂体腺瘤, 18例非侵袭性垂体腺瘤, 6例复发性垂体腺瘤中CD44s、CD44v5蛋白的表达。结果: 20例侵袭性垂体腺瘤中CD44s、CD44v5阳性率分别为 75%、35%, 18例非侵袭性垂体腺瘤中CD44s、CD44v5阳性率分别为 27. 8%、22. 2%, 6例复发性垂体腺瘤中CD44s、CD44v5阳性率分别为 100%、66. 7%。CD44s在侵袭性垂体腺瘤及复发性垂体腺瘤中的阳性表达率均明显高于非侵袭性垂体腺瘤,其差异具有显著性 (P<0. 01),CD44v5在侵袭性垂体腺瘤中和非侵袭性垂体腺瘤中的表达率均较低,无显著性差异(P>0. 05),但在复发性垂体腺瘤中有较高表达率。结论:CD44s在侵袭性垂体腺瘤中呈高表达,与垂体腺瘤的侵袭性生长有关,在垂体腺瘤的侵袭性生长过程中起重要作用,有可能作为侵袭性垂体腺瘤的一个诊断指标。CD44v5在垂体腺瘤中的表达较低,与垂体腺瘤生长方式无关。复发性垂体腺瘤中CD44s、CD44v5的高表达表明其预后较差。     

表皮生长因子受体在垂体腺瘤中的表达和临床意义

目的在垂体腺瘤组织中检测表皮生长因子受体(EGFR)的表达水平并分析其与临床病理类型、肿瘤增殖情况、侵袭性等的关系,为垂体瘤诊断和治疗提供理论依据和临床指导。方法选取65例垂体腺瘤患者术前血清、15例正常志愿者血清,采用酶联免疫分析技术对其EGFR水平进行检测。结果①EGFR水平在侵袭性组为(11.58±0.72)ng/mL、非侵袭性组为(11.44±0.68)ng/mL,与对照组(11.26±0.87)ng/mL相比有明显差异(P<0.05),且侵袭性组明显高于非侵袭性组(P<0.05)。②EGFR水平在垂体微腺瘤组、垂体大腺瘤组、垂体巨大腺瘤组中分别为(11.36±0.17)ng/mL、(11.45±0.69)ng/mL、(11.67±0.62)ng/mL,与对照组(11.26±0.87)ng/mL相比有明显差异(P<0.05);EGFR在垂体腺瘤各组间存在明显差异(P<0.001),且与垂体腺瘤大小呈正相关。③EGFR水平在功能性垂体腺瘤组为(11.52±0.52)ng/mL,与非功能性垂体腺瘤组(11.48±0.71)ng/mL比较无明显差异(P>0.05),且功能性垂体腺瘤各组中无明显差异。结论术前EGFR的检测可以在一定程度上反映垂体腺瘤的增殖情况,术前EGFR的检测有可能成为诊断垂体腺瘤侵袭性和评估预后的良好生物学指标。     

侵袭性垂体腺瘤中MMP-2和TIMP-2的表达及其相互关系的研究

目的探讨基质金属蛋白酶-2(MMP-2)和组织金属蛋白酶抑制物-2(TIMP-2)在垂体腺瘤中的表达及其与垂体腺瘤侵袭性的相关性。方法用免疫组化SP法和RT-PCR法检测55例垂体腺瘤标本的MMP-2及TIMP-2的表达,分析其与侵袭性垂体腺瘤的关系及两者之间的相关性。结果免疫组化显示MMP-2在侵袭性垂体腺瘤的强阳性及阳性表达率分别为65.6%和93.8%,明显高于非侵袭性垂体腺瘤的13.1%和43.5%(P<0.05或P<0.01)。侵袭性和非侵袭性垂体腺瘤的TIMP-2强阳性表达率分别为6.3%和43.5%(P<0.01),阳性表达率分别为50.0%和82.6%(P<0.05)。RT-PCR显示侵袭性垂体腺瘤的MMP-2 mRNA表达明显高于非侵袭性垂体腺瘤(1.126±0.081,0.425±0.083,P<0.01)。侵袭性腺瘤组TIMP-2 mRNA表达(0.209±0.032)较非侵袭性腺瘤组(0.768±0.050)显著降低(P<0.01)。侵袭性腺瘤组中MMP-2与TIMP-2 mRNA表达呈负相关(r=-0.67,P<0.05),而非侵袭性腺瘤组中无相关性(r=-0.24,P>0.05)。结论MMP-2高表达及TIMP-2低表达与垂体腺瘤的侵袭性密切相关,MMP-2及TIMP-2可以作为垂体腺瘤侵袭性的有效参考指标。     

侵袭性垂体腺瘤表达基质金属蛋白酶-2的意义

目的　探讨基质金属蛋白酶 2 (matrixmetalloproteinase2 ,MMP 2 )的表达与侵袭性垂体腺瘤相关性研究 .以寻找垂体腺瘤侵袭性可能的发病机制 .方法　用免疫组化的方法对 54例垂体瘤患者的组织标本进行研究 .并对其中 1 6例患者采用逆转录 聚合酶链反应 (RT PCR)的方法对MMP 2mRNA的表达进行研究 .免疫组化结果用半定量的方法进行分析 .结果　54例垂体瘤患者中 ,1 2例为侵袭性垂体腺瘤 ,4 2例为非侵袭性垂体腺瘤 .免疫组化显示 ,侵袭性垂体腺瘤的MMP 2的表达明显高于非侵袭性垂体腺瘤 (分别为 3 9± 1 6 ,2 3± 1 4 ,P <0 0 0 1 ) .大型垂体腺瘤和微垂体腺瘤 ,以及功能性和非功能性垂体腺瘤的MMP 2的表达则无明显差别 .MMP 2的表达与Ki 6 7的表达无明显相关性 (r=- 0 0 5;P >0 0 5) .侵袭性垂体腺瘤MMP 2mRNA的表达 ,明显高于非侵袭性垂体腺瘤 (P <0 0 5) .结论　MMP 2的高表达与肿瘤的侵袭性密切相关 ,但与肿瘤的大小及分泌功能无明显关系 .MMP 2可以作为肿瘤侵袭性一项有效的指标 .     

Ki-67抗原在侵袭性垂体腺瘤中的表达研究

目的　探讨垂体腺瘤中Ki- 6 7抗原表达与垂体腺瘤侵袭性的关系。方法　采用新一代鼠抗人Ki- 6 7单克隆抗体MIB - 1免疫组化LSAB法对 5 2例侵袭性垂体腺瘤和 35例非侵袭性垂体腺瘤中的Ki- 6 7抗原表达进行检测 ,以MIB - 1增殖细胞指数 (MIB - 1PCI)表示。对侵袭性腺瘤和非侵袭性腺瘤组间、有海绵窦侵袭腺瘤和无海绵窦侵袭腺瘤组间的MIB - 1PCI进行比较。结果　侵袭性垂体腺瘤组MIB - 1PCI为 (3.5 9± 2 .6 7) % ,非侵袭性垂体腺瘤组为 (2 .2 3± 2 .38) % ,2组间有显著性差异 (P <0 .0 5 ) ;海绵窦侵袭腺瘤组MIB - 1PCI为 (5 .4 2±5 .87) % ,无海绵窦侵袭腺瘤组为 (2 .6 3± 2 .86 ) % ,差异有显著性 (P <0 .0 1)。结论　Ki - 6 7抗原表达可以作为反映垂体腺瘤增殖潜能、侵袭性和侵袭程度的标志物 ,具有较高的临床应用价值     

外周血血管内皮生长因子在垂体腺瘤患者的表达

目的探讨外周血中血管内皮生长因子(vascular endothelial growth factor,VEGF)的表达水平是否可反映垂体腺瘤的生物行为.方法以203例垂体腺瘤患者、22例垂体增生患者、7例垂体Rathke囊肿患者及3例垂体脓肿患者为研究对象,并以20例正常献血者为对照组,用酶联免疫吸附法测定各组外周血中VEGF水平.结果在垂体疾病患者中,垂体腺瘤患者的血清VEGF水平为(366.8±211.1)pg/ml,垂体增生患者为(286.8±107.6)pg/ml,分别高于垂体Rathke囊肿患者(180.5±61.7)pg/ml、垂体脓肿患者(147.5±46.3)pg/ml和正常对照组(180.8±56.2)pg/ml,差异均具有显著性(P＜0.05).在垂体腺瘤患者中,大腺瘤(380.0±234.5)pg/ml和巨大腺瘤(380.1±280.3)pg/ml分别高于微腺瘤(294.6±111.6)pg/ml和垂体增生,差异有显著性差异(P＜0.05).而血清VEGF在垂体腺瘤是否具有侵袭性生长、卒中、囊性变和激素分泌类型上表达无差异(P＞0.05).结论外周血VEGF水平可反映垂体腺瘤生长大小的生物学行为,不能反映垂体腺瘤是否具有侵袭性生长、出血卒中、囊性变及激素分泌类型.检测外周血中VEGF水平对垂体腺瘤与垂体Rathke囊肿、垂体脓肿的鉴别可能具有一定的参考价值.     

垂体腺瘤的血管生成、瘤细胞的凋亡与侵袭性的关系

目的　探讨微血管密度 (Microvesseldensity,MVD)、瘤细胞凋亡 (Apoptosis)与肿瘤侵袭性的关系。方法应用EnVision二步法免疫组化技术检测 5 8例垂体腺瘤的微血管密度 (MVD) ;应用流式细胞术 (Flowcytometry ,FCM)对 38例垂体腺瘤 (12例侵袭性腺瘤 )检测瘤细胞凋亡情况 ;分为侵袭组和非侵袭组进行统计学分析 ,并对MVD与瘤细胞凋亡进行相关性分析。结果　侵袭性垂体腺瘤MVD为 6 .78± 1.6 7;非侵袭性垂体腺瘤MVD为 3.72± 1.0 2 ;差异有显著性 (P <0 .0 1)。肿瘤细胞的凋亡百分比 ,侵袭性为 11.5 2± 6 .77(% ) ,非侵袭性为 6 .0 5± 4 .82 (% ) ,两者相比有显著性差异 (P <0 .0 1)。侵袭性垂体腺瘤细胞凋亡率高 ,垂体腺瘤的异倍体率为 6 3.2 % ,其中侵袭性垂体腺瘤为 87.5 % ,非侵袭性腺瘤为 4 5 .5 % ,两者相比有显著性差异 (P <0 .0 5 )。直线相关分析显示 ,MVD与瘤细胞凋亡呈显著正相关 (r=0 .6 12 ,P <0 .0 5 )。结论　侵袭性垂体腺瘤MVD增高、DNA倍增明显 ,同时肿瘤细胞凋亡也增加。     

血清表皮生长因子受体水平在垂体腺瘤增殖诊断中的作用

目的　探讨血清表皮生长因子受体 (EGF R)水平与垂体腺瘤患者瘤前病变和肿瘤增殖的关系。方法　采用酶联免疫分析技术对 137例垂体疾病患者的术前血清EGF R胞外区表达水平进行检测。患者中 5例为垂体Rathke囊肿 ,13例垂体增生 ,119例垂体腺瘤患者 ,其中微腺瘤 17例、大腺瘤 6 4例、巨大腺瘤 38例 ,2 8例正常献血者为对照组。结果　血清EGF R水平在垂体增生患者中为194fmol/L± 38fmol/L ,在垂体微腺瘤、垂体大腺瘤、垂体巨大腺瘤患者中分别为 2 19fmol/L± 37fmol/L、32 2fmol/L± 6 6fmol/L、4 2 8fmol/L± 6 2fmol/L ,均明显高于垂体Rathke囊肿患者 (15 2fmol/L± 17fmol/L ,P <0 0 0 0 1)和对照组 (15 9fmol/L± 4 1fmol/L ,P <0 0 5 )。血清EGF R水平与垂体腺瘤大小呈正相关 (r=0 998) ,并在垂体腺瘤患者各组间存在明显差异 (P <0 0 0 0 1)。结论　检测垂体腺瘤患者术前血清EGF R水平可反映肿瘤的增殖状况 ,可能有助于垂体腺瘤和垂体Rathke囊肿的鉴别诊断。建议血清EGF R可作为反映垂体腺瘤增殖的一种分子参考标志     

ELEVATED SOLUBLE EPIDERMAL GROWTH FACTOR RECEPTOR LEVEL IN PITUITARY ADENOMA AND CARCINOMA

Objective To investigate effect of the soluble epidermal growth factor receptor (sEGFR/sErbB1) level in the peripheral blood in development, invasiveness, apoplexy of each type of pituitary tumor.Methods The sEGFR level was determined in peripheral serum from 190 patients with pituitary diseases by enzyme linked immunosobent assay. The sEGFR levels were measured in 10 pituitary Rathke's pouch, 18 pituitary hyperplasia, 161pituitary adenomas including 30 microadenomas, 83 large adenomas, 48 giant adenomas, 1 pituitary carcinoma, and 28 healthy controls.Results In the patients with pituitary hyperplasia, microadenoma, large adenoma, giant adenoma, and pituitary carcinoma, the sEGFR level was 188.92 32.62, 209.83 19.01,333.20 69.33, 405.85 37.38, and 617.45 fmol/mL independently. They were all significantly higher than patients with pituitary Rathke's pouch (156.78 18.24 fmol/mL, P ＜ 0.001)and healthy control group (159.11 40.50 fmol/mL, P ＜ 0.05). The sEGFR level in pituitary carcinoma was higher than pituitary adenoma. In patients with pituitary adenoma, the sEGFR level was positive correlated to the size of pituitary adenomas (r = 0.998), the significant difference was observed for the sEGFR level in each group of the patients with pituitary adenomas (P ＜ 0.001). Furthermore, in patients with pituitary ACTH-secrefing microadenomas, the serum sEGFR levels in invasiveness (295.00 77.80 fmol/mL) was higher than that in non-invasiveness (210.60 16.4 fmol/mL, P ＜ 0.05). In patients with pituitary ACTH-secreting, PRL-secreting, GH-secreting, and non-functioning large adenomas, the serum sEGFR levels in invasiveness (407.86 28.50, 399.25 30.10, 386.00 13.08, and 369.25 36.70 fmol/mL) was higher than that in non-invasiveness (335.25 63.49, 300.64 47.57, 297.00 61.93, and 269.30 25.68 fmol/mL) respectively (P ＜ 0.05). In patients with invasive pituitary PRL-secreting, GH-secreting, and non-functioning giant adenomas, the serum sEGFR levels not significantly different in between invasiveness (417.50 35.94, 409.50 69.14, and 417.50 44.13 fmol/mL) and noninvasiveness (386.00 49.64, 417.50 44.03, and 409.51 35.17 fmol/mL) (P ＞ 0.05). In patients with pituitary large adenomas, the sEGFR levels in pituitary apoplexy (377.48 39.18 fmol/mL) was higher than that in non-pituitary apoplexy(343.18 68.17 fmol/mL, P ＞ 0.05).Conclusions The increased level of peripheral serum sEGFR is concomitant with development, proliferous size of the adenomas in patients with pituitary adenomas. In addition, the elevated levels of serum sEGFR occur in pituitary apoplexy as clinical active tumors, and the non-invasive ACTH secreting adenomas. The sEGFR levels could be differentiated helpfully between pituitary adenomas and non-pituitary adenomas. These data suggest that serum sEGFR could be as a referable marker of the size and activation of proliferation in pituitary adenoma.     

经单鼻孔蝶窦入路切除垂体腺瘤

目的总结单侧鼻孔(右侧)经蝶入路垂体腺瘤切除术的手术经验及体会.方法对20例垂体腺瘤病人采用经单鼻孔蝶窦入路行显微镜直视下垂体腺瘤切除手术,其中垂体微腺瘤2例,大腺瘤16例,巨大腺瘤2例.结果12例肿瘤获全切,4例大部切除,4例部分切除.所有病人术后内分泌症状均有不同程度改善.术后尿崩症3例,脑脊液鼻漏2例,经治疗出院时均恢复正常.结论此入路有手术距离缩短、损伤小、省时、简单、并发症少等优点.     

EFFECT OF PREOPERATIVE USE OF LONG-ACTING OCTREOTIDE ON GROWTH HORMONE SECRETING PITUITARY ADENOMA AND TRANSSPHENOIDAL SURGERY

TRANSSPHENOIDAL surgeryisgenerallyaccepted asinitialtreatmentofgrowthhormone (GH )secre- tingpituitaryadenoma .1However , surgicalremis-sionrateisconsiderablylower forpatientswith largertu-mors.Over 50% ofpatientswithtumors more than2 cm indiameteralongwithextrasellarextensionwillstillhave highpostoperativeGH levelsdue totumor'slargesizeand inva-sivecharacteristic.2Idealpituitarytumor treatmentshouldenabletumor growth control,sizereduction,tumor pressureeffectsrelief,and pituitaryhormon…     

Study on the Expression Levels of CXCR4, CXCL12, CD44, and CD147 and Their Potential Correlation with Invasive Behaviors of Pituitary Adenomas

Objective To evaluate the factors of CXCR4, CXCL12, CD44, and CD147 as early potential diagnostic biomarkers by determining their expression levels in invasive and non-invasive pituitary adenomas. Methods Fresh pituitary adenoma specimens were collected from 35 pituitary adenoma (21 invasive and 14 non-invasive) patients who underwent surgical treatment in our Neurosurgery Department between January and April of 2009. The expression levels of CXCR4, CXCL12, CD44, and CD147 were evaluated firstly by flow cytometry, fluorescence microscopy in single cell suspensions, and then by immunohistochemical staining of paraffin tissue sections. Results Flow cytometric analyses showed that the percentage of CXCR4-and CXCL12-positive cells from invasive pituitary adenomas (IPA) was significantly higher in the single cell suspensions than that from non-invasive pituitary adenomas (nIPA) (P<0.05). Immunohistochemical staining revealed that CXCR4 and CXCL12 staining index scores of the invasive pituitary adenomas were significantly higher than those of the non-invasive pituitary adenomas (P<0.05). In contrast, neither flow cytometry nor immunohistochemical staining demonstrated significant difference between CD44 and CD147 expression levels, respectively. Conclusion Expression levels of CXCR4 and CXCL12 are correlated with the invasiveness of pituitary adenomas. Therefore, rather than CD44 and CD147, CXCR4 and CXCL12 may potentially serve as biomarkers for early detection of pituitary adenomas.     

Transsphenoidal microsurgical removal of large pituitary adenomas

OBJECTIVE To retrospectively analyze the diagnostic modes, transsphenoidal microsurgical technique and outcomes of 145 patients with pituitary macroadenoma or giant pituitary adenoma.

METHODS A total of 145 patients suffering from pituitary macroadenoma or giant pituitary adenoma with suprasellar extension were performed with transsphenoidal microsurgery in our department. Diagnoses were made by CT or MRI scanning. All adenomas had suprasellar extension (extension size: > 10 mm). Operations were performed via either sublabio-septo-sphenoidal approach or naso-vestibulo-sphenoidal approach under microscope. During operation, a subarachnoid catheter was inserted into the lumbar cistern, via the catheter saline was slowly injected to increase the intracranial pressure (ICP) and to deliver the suprasellar tumor into the operative field for easy removal.

RESULTS The gross total removal of adenoma in 102 patients (70.4%) and subtotal removal in 35 patients (24.1%) were achieved; partial removal was carried out in the remaining 8 patients (5.5%) with fibrous or dumbbell-shaped adenomas. There were no deaths after surgery. Long-term follow-up observation (median: 3.5 years) in 132 patients revealed good recovery in 93 (70.5%) and late recurrence in 39 (29.5%). Those patients with tumor recurrence underwent reoperation, drug therapy, radiotherapy, and radiosurgery either alone or in combination.

CONCLUSIONS Except for fibrous and dumbbell-shaped ones, microsurgical technique via transsphenoidal approach is a safe and effective way to remove large pituitary adenomas.

     

垂体腺瘤中CXCR4、VEGF的表达及其与侵袭性之间的关系

目的观察基质细胞衍生趋化因子-1（SDF-1）受体CXCR4及血管内皮生长因子（VEGF）在垂体腺瘤中表达水平,为侵袭性垂体腺瘤的治疗提供理论和实验依据。方法采用免疫组化SABC方法检测9例非侵袭垂体腺瘤及39例侵袭性垂体腺瘤（Ⅰ级15例,Ⅱ级14例,Ⅲ级10例）瘤组织中CXCR4及VEGF水平。采用多功能真彩色病理分析系统进行免疫组化分析。结果 39例侵袭性垂体腺瘤和9例非侵袭性垂体腺瘤均可见CXCR4和VEGF的表达。非侵袭性垂体腺瘤患者与侵袭性垂体腺瘤患者比较,CXCR4和VEGF的表达差异均有统计学意义（P〈0.05）,Ⅲ级侵袭腺瘤的CXCR4及VEGF表达均高于Ⅰ级与Ⅱ级侵袭性垂休腺瘤及非侵袭性垂体腺瘤,差异有统计学意义（P〈0.05）,Ⅱ级侵袭性垂体腺瘤表达高于非侵袭垂体腺瘤,差异有统计学意义（P〈0.05）。CXCR4的表达与VEGF的表达之间存在明显相关（r=0.653,P〈0.01）。结论 CXCR4及VEGF在侵袭性垂体腺瘤的表达明显高于非侵袭性垂体腺瘤,且随着侵袭程度的加剧而增高,与垂体腺瘤的侵袭性相关;CXCR4与VEGF呈正的直线相关关系,对垂体腺瘤的侵袭性生物学行为的评估有重要意义,并为临床制定合理的治疗方案、预后判断及疗效评定提供客观参考依据。     

垂体腺瘤切除术中内窥镜的应用(附13例病例分析)

目的：探讨内窥镜技术在直接经鼻蝶垂体腺瘤切除术中的应用。方法：２０００年３月～２０００年８月在１３例直接经鼻蝶垂体腺瘤切除术中应用内窥镜技术,其中垂体微腺瘤３例、大腺瘤１０例。内窥镜直接由单鼻孔进入,８例在鼻前庭作切口、５例未作鼻腔皮肤粘膜切口,内窥镜下显露蝶窦开口,找开蝶窦,经鞍底切除肿瘤。结果：１３例患随访１个月～５个月,平均３个月。术前１０例内分泌检查异常患术后复查激素水平均降至正常：ＭＲＩ术前、后对照,１０例肿瘤全部切除,３例在海绵窦残余部分肿瘤。术后发生暂时性尿崩症３例、１例发生脑脊液鼻漏,经二次手术修补治愈。结论：在直接经鼻蝶垂体腺瘤手术中应用内窥镜技术有利于良好显露术野和彻底切除肿瘤,疗效满意,并发症少,值得进一步推广。