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

Detection of serum epidermal growth factor receptor in the diagnosis of proliferation of pituitary adenomas

OBJECTIVE: To investigate the correlation between preoperative serum epidermal growth factor receptor (EGF-R) level and proliferation of pituitary adenoma. METHODS: ELISA was used to determine the levels of EGF-R in preoperative serum from 137 patients with pituitary diseases: 5 cases of pituitary Rathke's pouch, 13 cases of pituitary hyperplasia, and 119 cases of pituitary adenomas including 17 cases of microadenoma, 64 cases of macroadenoma, and 38 cases of giant adenoma. Twenty-eight healthy blood donors were used as controls. RESULTS: The level of serum EGF-R was (194 +/- 38) fmol/L in patients with pituitary hyperplasia, and was (219 +/- 37) fmol/L in patients with pituitary microadenoma, 322 +/- 66 fmol/L in patients with pituitary macroadenoma and (428 +/- 62) fmol/L in patients with pituitary giant adenoma. The levels of serum EGF-R in patients with different kinds of pituitary hyperplasia and pituitary adenoma were significantly higher than the level in patients with pituitary Rathke's pouch (152 +/- 17) fmol/L, all P < 0.0001, and were significantly higher than that in healthy control group (159 +/- 41) fmol/L, all P < 0.05. The serum level of EGF-R was positively correlated to the size of pituitary adenoma (r = 0.998). Furthermore, significant difference in the level of serum EGF-R was observed among patients with different kinds of pituitary adenoma (P < 0.0001). CONCLUSION: EGF-R level in preoperative serum of patients with pituitary adenoma reflexes the proliferative status of pituitary adenoma and helps differentiate pituitary adenoma from pituitary Rathke's pouch. It is suggested that serum EGF-R be used as a referable marker of proliferative status of pituitary adenoma.