侵袭性垂体腺瘤的临床特点与诊治方法

目的 探讨侵袭性垂体腺瘤的临床特点与诊治方法.方法 回顾分析经蝶手术治疗的62例侵袭性垂体腺瘤的临床表现、影像学表现及治疗效果,并结合同期78例非侵袭性垂体腺瘤的临床资料进行对比研究.结果 大腺瘤和巨大腺瘤的侵袭性腺瘤发生率为67.5%,明显高于微腺瘤和小腺瘤的15.9%(P＜0.01);功能性腺瘤和非功能性腺瘤中的侵袭性腺瘤发生率无显著性差异(P＞0.05);侵袭性腺瘤中垂体腺瘤卒中的发生率为22.6%,明显高于非侵袭性腺瘤的5.1%(P＜0.01);侵袭性腺瘤中复发性腺瘤所占比例为16.1%,明显高于非侵袭性腺瘤的3.8%(P＜0.05);侵袭性腺瘤的手术全切率(46.8%)明显低于非侵袭性腺瘤(88.5%,P＜0.01).结论 侵袭性垂体腺瘤的诊断应结合影像学检查、术中所见和病理学检查来综合判定.术后复发率高,故治疗应采取手术治疗结合放射治疗和药物治疗的综合治疗.

Clinical characteristics, diagnosis and treatment of invasive pituitary adenomas

Objective To investigate the clinical characteristics,diagnosis and treatment of invasive pituitary adenoma.Methods The clinical presentations,imaging studies and surgical outcomes in 62 patients with invasive pituitary adenomas and 78 patients with noninvasive pituitary adenomas were analyzed retrospectively.Results Invasive pituitary adenomas were more common in patients with macroadenomas than those with microadenomas(P<0.01).The occurrence of pituitary apoplexy was higher in invasion pituitary adenomas patients than those non-invasion(P<0.01).The rate of total tumor resection was lower and the rate of postoperative recurrence was higher in patients with invasive tumors than those with noninvasive tumors(P<0.05,0.01).Conclusion The diagnosis of invasive pituitary adenomas should be made according to preoperative radiological signs,surgical findings and postoperative pathological examinations.Tumor resection is usually partial,adjuvant treatment(radiotherapy or medication)is often necessary in invasive pituitary adenoma patients.