128例垂体腺瘤回顾性分析

Pituitary adenoma:retrospective analysis of 128 cases

目的探讨垂体腺瘤临床特征、免疫组化以及内分泌变化规律。方法回顾研究资料完整的垂体瘤手术病例128例,收集相关的临床资料,组织标本行免疫组化检查。结果根据免疫组化结果对病例进行分类,无激素表达腺瘤占总数的17.2%,单激素阳性的腺瘤占37.5%,其中7例催乳激素(PRL)阳性表达,12例生长激素(GH)阳性表达,促肾上腺皮质激素(ACTH)阳性14例,其他几种阳性合计15例,双激素阳性表达腺瘤占25%,多激素阳性腺瘤占20.5%。结论免疫组化结果与临床内分泌变化不完全一致;除肿瘤占位效应外可能还存在其他调节机制,影响PRL阴性表达垂体肿瘤中PRL水平增高;垂体腺瘤组织学类型具有多样性和复杂性特点。

Objective To study clinical, biological behavior, immunohistochemical and endocrinological characters of pituitary adenoma. Methods A total of 128 cases of pituitary adenoma were investigated clinically. PRL, GH, ACTH, TSH, LH and FSH were examined by ABC inmunocytochemical method. Results All the cases of pituitary adenoma classified by immunohistochemistry were as follows： 17.2 % were nonhormonal adenoma, 37.5 % were monohormonal adenoma, including 7 cases of prolactin adenoma, 12 cases of growth hormonal adenoma, 14 cases of adrenocorticotropic hormonal adenoma, 15 cases of other hormonal adenoma,25.0% were double hormonal adenoma and 20.3 % were multiple hormone-expression adenorna including three kinds of hormones and more. Condusion Immunohistochemical results are not always consistent with clinical manifestations. Other mechanism may participate into the hyperprolactinemia of non-prolactin-expression pituitary adenoma apart from compression effect of tumors. Based on the resuits of immunohistochemistry, it can conclude that pituitary adenoma is of diversity and complexity.