目的:探讨超重/肥胖患者肝细胞腺瘤(hepatocellular adenoma,HCA)基因组微卫星不稳定性(microsatellite instability,MSI)的发生特点和临床病理学意义。方法:回顾性分析166例手术切除HCA患者的性别构成和体重指数(body mass index,BMI,k...目的:探讨超重/肥胖患者肝细胞腺瘤(hepatocellular adenoma,HCA)基因组微卫星不稳定性(microsatellite instability,MSI)的发生特点和临床病理学意义。方法:回顾性分析166例手术切除HCA患者的性别构成和体重指数(body mass index,BMI,kg/m2)等特点,采用石蜡切片显微组织切割基础上的单链构象多态性(PCR-SSCP)检测方法,选取与脂肪代谢、糖代谢、肥胖和雌激素代谢通路相关的5个基因相连锁的12个微卫星,随机对其中60例HCA患者,包括34例超重/肥胖患者的HCA组织中进行微卫星MSI检测。结果:在166例HCA中男114例,女52例。154例有完整BMI数据的HCA患者中超重/肥胖患者53.9%(83/154),其中男74例(89.2%),女9例(10.8%),男性患者的BMI平均为(25.78±0.75)kg/m2显著高于女性的(21.70±0.81)kg/m2,P=0.001。34例超重/肥胖患者HCA中,微卫星D12S1398发生MSI-H的频率为75.0%,显著高于MSI-L的31.2%,P=0.013;D6S1064发生MSI-H的频率为78.5%,显著高于MSI-L的33.3%,P=0.020。结论:与西方国家报道的HCA患者不同,中国HCA的发生以男性超重/肥胖患者多见,其发生可能与HNF-1α(D12S1398)和HIPPO(D6S1064)等代谢通路紊乱有关。微卫星MSI检测有助于临床了解HCA可能的病因和发生机制以及基因组不稳定性程度。展开更多
Background Surgery of pituitary adenomas invading cavernous sinus has always been thought as a challenge due to the complex anatomical structures and high risk of complications. The purpose of this study was to evalua...Background Surgery of pituitary adenomas invading cavernous sinus has always been thought as a challenge due to the complex anatomical structures and high risk of complications. The purpose of this study was to evaluate endoscopic trarssphenoidal approach to pituitary adenomas invading cavernous sinus.Methods The clinical data of 22 patients who admitted to Xuanwu Hospital with pituitary adenomas invading cavernous sinus were analyzed retrospectively. All patients underwent endoscopic transsphenoidal surgery. To expose the surgical field sufficiently, the opening of sellar floor was exceeded the bone overlying the invaded cavernous sinus, and synthetic dura was used to repair and strengthen the sella floor for preventing the leak of cerebrospinal fluid.Results Among 22 patients, total resection was achieved in 14, subtotal resection in 5, and partial resection in 3; no patient underwent insufficient resection. Visual symptoms improved in 7 of 9 patients. In one patient diplopia disappeared.Headache was relieved to various extents in all patients. No serious complications were found. Patient＇s hospital stay ranged from 7 to 20 days.Conclusion These data suggest that the endoscopic transsphenoid approach is a safe, minimally invasive, and efficient surgical technique, which might be an important therapeutic strategy for the pituitary adenoms invading cavernous sinus.展开更多
文摘目的:探讨超重/肥胖患者肝细胞腺瘤(hepatocellular adenoma,HCA)基因组微卫星不稳定性(microsatellite instability,MSI)的发生特点和临床病理学意义。方法:回顾性分析166例手术切除HCA患者的性别构成和体重指数(body mass index,BMI,kg/m2)等特点,采用石蜡切片显微组织切割基础上的单链构象多态性(PCR-SSCP)检测方法,选取与脂肪代谢、糖代谢、肥胖和雌激素代谢通路相关的5个基因相连锁的12个微卫星,随机对其中60例HCA患者,包括34例超重/肥胖患者的HCA组织中进行微卫星MSI检测。结果:在166例HCA中男114例,女52例。154例有完整BMI数据的HCA患者中超重/肥胖患者53.9%(83/154),其中男74例(89.2%),女9例(10.8%),男性患者的BMI平均为(25.78±0.75)kg/m2显著高于女性的(21.70±0.81)kg/m2,P=0.001。34例超重/肥胖患者HCA中,微卫星D12S1398发生MSI-H的频率为75.0%,显著高于MSI-L的31.2%,P=0.013;D6S1064发生MSI-H的频率为78.5%,显著高于MSI-L的33.3%,P=0.020。结论:与西方国家报道的HCA患者不同,中国HCA的发生以男性超重/肥胖患者多见,其发生可能与HNF-1α(D12S1398)和HIPPO(D6S1064)等代谢通路紊乱有关。微卫星MSI检测有助于临床了解HCA可能的病因和发生机制以及基因组不稳定性程度。
文摘Background Surgery of pituitary adenomas invading cavernous sinus has always been thought as a challenge due to the complex anatomical structures and high risk of complications. The purpose of this study was to evaluate endoscopic trarssphenoidal approach to pituitary adenomas invading cavernous sinus.Methods The clinical data of 22 patients who admitted to Xuanwu Hospital with pituitary adenomas invading cavernous sinus were analyzed retrospectively. All patients underwent endoscopic transsphenoidal surgery. To expose the surgical field sufficiently, the opening of sellar floor was exceeded the bone overlying the invaded cavernous sinus, and synthetic dura was used to repair and strengthen the sella floor for preventing the leak of cerebrospinal fluid.Results Among 22 patients, total resection was achieved in 14, subtotal resection in 5, and partial resection in 3; no patient underwent insufficient resection. Visual symptoms improved in 7 of 9 patients. In one patient diplopia disappeared.Headache was relieved to various extents in all patients. No serious complications were found. Patient＇s hospital stay ranged from 7 to 20 days.Conclusion These data suggest that the endoscopic transsphenoid approach is a safe, minimally invasive, and efficient surgical technique, which might be an important therapeutic strategy for the pituitary adenoms invading cavernous sinus.
