无功能垂体腺瘤术后复发相关因素分析

Analysis of the related factors of post-operative recurrence of nonfunctional pituitary adenoma

目的研究无功能垂体腺瘤术后复发的相关因素。方法对113例无功能垂体腺瘤患者的临床资料、治疗方法及随访结果进行logistic回归分析。结果术后复发与腺瘤侵袭性、手术切除程度、术后辅助治疗相关且差异显著(P<0.05)。侵袭性腺瘤的术后复发风险高于非侵袭性腺瘤;手术未能全切、术后未行辅助治疗者术后复发风险也较高。根据标准回归系数,术后辅助治疗对降低无功能垂体腺瘤术后复发风险的作用最大,其次依次为手术全切、腺瘤非侵袭性。其他因素如年龄、性别、瘤体大小等因素与复发无明显相关性。结论无功能垂体腺瘤术后复发是多因素作用的结果,临床工作者应正确、全面地认识这些因素的作用以便采取多种治疗措施降低无功能垂体腺瘤的术后复发率。

Objective To study the related factors of post-operative recurrence of nonfunctional pituitary adenoma. Methods The clinical data, therapeutic methods and following-up outcome of 113 patients of nonfunctional pituitary adenoma were recorded and statistically analyzed with logistic regression model. Results Recurrence after surgery was related to the invasion of adenomas, the resection range and the adjunct therapy after surgery. All these factors showed significant difference （P 〈 0. 05）. The recurrent risk of invasive adenoma was higher than that of non-invasive adenoma. The high risk of recurrence also presented in patients with non-total resection or patients without post-operative adjunct therapy. According to the standard regression coefficient, the factor of the adjunct therapy played the most important role in reducing the recurrence rate of nonfunctional pituitary adenoma. The factor of the total resection after surgery was secondary and the factor of the invasion of adenoma was least. Other factors such as age, sex and the size were unrelated to the recurrence of nonfunctional pituitary adenoma. Conclusion Many factors contribute to the post-operative recurrence of nonfunctional pituitary adenoma. Clinical surgeons should be acquainted with them correctly, so comprehensive therapy can be taken to reduce the recurrence of nonfunctional pituitary adenoma.