内分泌激素水平在功能性垂体腺瘤患者手术疗效中的评估价值

doi:10.3969/j.issn.1006-6233.2018.04.009

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摘要 目的:探讨内分泌激素水平在功能性垂体腺瘤患者手术疗效中的评估价值。方法:根据手术切除程度将500例功能性垂体腺瘤[其中泌乳激素(PRL)型273例,生长激素型(GH)型227例]患者分为全切组与未全切组,对患者术前、术后1d、3d、7d血清PRL、GH水平测定,并比较全切组与未全切组患者上述指标;另随访评价其肿瘤控制情况,通过受试者工作曲线(ROC)分析PRL、GH对PRL型、GH型垂体腺瘤手术疗效的预测价值。结果:全切组术后1d、3d、7d血清PRL、GH水平均显著低于未全切组,差异有统计学意义(P<0.05);术后2年CT或MRI复查显示,PRL型垂体腺瘤全切患者肿瘤控制率97.00%,未全切患者肿瘤控制率31.51%;GH型垂体腺瘤全切患者肿瘤控制率85.54%,未全切患者肿瘤控制率54.10%;术后血清PRL预测PRL型垂体腺瘤患者2年肿瘤控制率曲线下面积(AUC)=0.899,敏感度78.52%,特异度88.10%,血清GH预测GH型垂体腺瘤患者2年肿瘤控制率最佳临界值为1.00nmoL/L,AUC=0.900,敏感度79.00%,特异度88.14%。结论:术后血清PRL、GH水平监测对PRL型、GH型垂体腺瘤患者手术切除程度、肿瘤复发有一定的预测价值。

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	唐光容
	樊朝凤
	戴和伶

关键词 ：功能性垂体腺瘤, 内分泌激素, 相关性

Abstract：Objective: To investigate the value of changes of endocrine hormone levels in evaluating the effects of surgical treatment for patients with functional pituitary adenoma. Methods: According to the degree of surgical resection, 500 patients with functional pituitary adenoma, including 273 patients with prolactin (PRL) type and 227 patients with growth hormone (GH) type were divided into the total resection group and the partial resection group. Serum levels of PRL and GH were determined before surgery, at 1 day, 3 days and 7 days after surgery. Above-mentioned indexes were compared between the total resection group and the partial resection group. The tumor control was evaluated during follow-up, and the value of PRL and GH in predicting the surgical effects on PRL type and GH type pituitary adenomas was analyzed by the receiver operating characteristic (ROC) curve. Results: Serum levels of PRL and GH in the total resection group at 1 day, 3 days and 7 days after surgery were significantly lower than those in the partial resection group (P<0.05). CT or MRI reexamination showed that the tumor control rates of patients with PRL type pituitary adenoma treated by total resection and patients not treated by total resection were 97.00% and 31.51% respectively. The tumor control rates of patients with GH type pituitary adenoma treated by total resection and patients not treated by total resection were 85.54% and 54.10%, respectively. The area under the curve (AUC), sensitivity and specificity of postoperative serum PRL in predicting the 2-year tumor control rate of patients with PRL type pituitary adenomas were 0.899, 78.52% and 88.10%, respectively. The optimal critical value, AUC, sensitivity and specificity of serum GH in predicting the 2-year tumor control rate of patients with GH type pituitary adenomas were 1.00nmol/L, 0.900, 79.00% and 88.14%, respectively. Conclusion: The monitoring of serum PRL and GH levels after operation has a certain predictive value for the degree of surgical excision and recurrence of PRL and GH pituitary adenomas.

Key words： Functional pituitary adenoma Endocrine hormone Correlation

基金资助:四川省卫生和计划生育委员会科研课题,(编号:1600326)

引用本文:

唐光容, 樊朝凤, 戴和伶. 内分泌激素水平在功能性垂体腺瘤患者手术疗效中的评估价值[J]. 河北医学, 2018, 24(4): 560-563.
TANG Guangrong, FAN Chaofeng, DAI Heling. Value of Endocrine Hormone Levels in Evaluating the Effects of Surgical Treatment for Patients with Functional Pituitary Adenoma. HeBei Med, 2018, 24(4): 560-563.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.04.009 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I4/560

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