106例累及鞍底硬膜的侵袭性垂体瘤的术后治疗及长期随访

The postoperative treatment and follow-up of 106 patients with invasive pituitary adenomas involving sella turcica basement dura

目的分析106例累及鞍底硬膜的侵袭性垂体瘤的术后治疗，探讨侵袭性垂体瘤的综合治疗。方法收集我科2000年1月至2006年12月106例累及鞍底硬膜的侵袭性垂体瘤的术后患者，并随访，随访时间6～72个月。结果侵袭性垂体腺瘤MRI影像学特点为鞍底受侵下陷，部分肿瘤突入蝶窦；颈内动脉包绕；海绵窦受累，鞍隔突破等。肿瘤全切87例（82．2％），复发6例（6．7％），化疗9例，放疗8例，临床症状及生活质量明显恢复的68例（64．2％），不明显的20例（18．9％），加重的18例（17．0％）。结论侵袭性垂体瘤的治疗，手术切除是关键，术后内分泌治疗和随访十分重要，必要时辅以放疗。

Objective To study the postoperative treatment of 106 patients with invasive pituitary adenomas involving sella turcica basement dura and to explore the combined therapy of invasive pituitary adenomas. Methods A total of 106 patients with invasive pituitary adenomas involving sella turcica basement dura from January 2000 to December 2006 were treated by transsphenoidal microsurgery and followed-up （ ranged from 6 to 72 months）. Results MRI findings of invasive pituitary adenoina included： invasion of the sella turcica and adjacent bones, involvement of sphenoid sinus and cavernous sinus, encasement of internal carotid artery, etc. Eighty-seven eases with invasive tumors were totally resected （82. 2% ）. Nine eases received chemotherapy after operation, 8 cases received radiotherapy, and 6 cases recurred （6.7%）. The clinical symptoms and the quality of life were conspicuous recovered in 68 cases （64.2%）, not obvious in 20 cases （18.9%）, and aggravated in 18 cases （ 17. 0% ）. Conclusion Operation is the key point of the treatment of invasive pituitary adenomas. Postoperative endocrine tberapy and long-term follow-up is essential, and postoperative radiotherapy should be carefully considered if necessary.