| Objective1. To analyze the clinical data of pituitary adenoma such as clinical manifestations, age, gender, pathological type, immunohistochemistry and imaging examination and to gain the experience of diagnosis and treatment in pituitary adenoma.2. To analyze the relativity between clinical symptoms and expression level of growth hormone, prolactin hormone through immunohistochemical method and serum hormone levels, hoping for providing evidence for diagnosis the pituitary adenoma.Methods1. The two hundred and thirty-two patients who were performed with pituitary adenoma surgery in our hospital nerve surgery department from Jun.2008to Jun.2011were enrolled in the research.The clinical information (age, gender, clinical manifestations, imaging examination, growth hormone level, prolactin hormone level, pathological type, immunohistochemistry and so on) was analyzed retrospectively.2. To resepectively analyze the relatitvty between the results of the immunohistochemical stains of two pituitary adenomas (growth hormone-secreting adenoma, prolactin hormone-secreting adenoma) and the serum relevant hormone levels and clinical symptom.Results 1. There were232patients who were diagnosed as pituitary adenoma after surgery。In our series, there are93nonfunctioning adenoma (NFPA),60prolactin hormone (PRL)-secreting adenoma,25growth hormone (GH)-secreting adenoma.The most frequent pathological type was nonfunctioning adenoma (40.1%), followed by prolactin hormone-secreting adenoma (25.9%), growth hormone-secreting adenoma (10.8%).There were only196patients having the tumor size record with170cases (86.7%) with macroadenoma and26(13.3%) microadenoma. Among the macroadenoma,127(74.7%) patients were males and43(25.3%) females. Among the microadenoma,11(42.3%) patients were males and15(57.7%) females.The average diameter:2.69±1.34cm (males),2.19±1.16cm (females).There are more males than females in the average diameter of pituitary adenoma (p<0.01)2. There were25patients who were diagnosed as growth hormone-secreting pituitary adenoma. The age at the time of diagnose range17-60. The median age is38. The series comprised11males and14females. The male female ratio was11/14wich has no statistical difference. Clinical manifestations:25patients complained of the symptoms caused by excessive hormone (e.g. face changing, acromegaly).18patients complained of compressive symptoms (e.g. headache, decrease of vision). Among25patients the average diameter:2.01±1.03cm (males),2.09±0.84cm (females).There are no statistically significant difference. GH-secreting adenoma was more ofen associated with macroadenoma than microadenoma.97.5%of the patients who were diagnosed as GH by immunohistochemical staining matched the clinical diagnostic criteria. In the patients with GH the serum relevant hormone levels and typical clinical symptom had the better consistency with immunohistochemical staining ldiagnosis.3. There were60patients who were diagnosed as prolactin hormone (PRL)-secreting adenoma. The age at the time of diagnose range10±63. The median age is44. The series comprised18males and42females. The male female ratio was18/42wich has significant difference (p<0.01). Clinical manifestations:37patients complained of the symptoms caused by excessive hormone (e.g. amenorrhoea, menstrual disorder, galactorrhea) while6patients complained of the symptoms caused by hormonoprivia (e.g. dysplasia).50patients complained of compressive symptoms (e.g. headache, decrease of vision). Among60patients the average diameter:2.86±1.17cm (males),1.63±0.92cm (females).There are significant difference in them (p<0.01). PRL pituitary adenoma in the males was more often associated with macroadenoma than in the females. The diameter of macroadenoma in the males was larger than that in the females.Regarding patients’serum PRL>200ng/ml、PRL>150ng/ml、PRL>100ng/ml as clinical diagnostic criteria:The patients who were diagnosed as pituitary adenoma by CT and MRI with serum PRL>100ng/ml as clinical diagnostic criteria, they had the highest consistency (91.3%) with pathological diagnosis.Conclusion1. In patients of pituitary adenoma the most frequent pathological type was nonfunctioning adenoma, followed by prolactin hormone-secreting adenoma, then growth hormone-secreting adenoma. GH-secreting adenoma was more ofen associated with macroadenoma than microadenoma. PRL pituitary adenoma in the males was more often associated with macroadenoma than in the females.The diameter of macroadenoma in the males was larger than that in the females.2. In the patients with GH the serum relevant hormone levels and typical clinical symptom had the better consistency with immunohistochemical staining diagnosis.3. The patients who were diagnosed as pituitary adenoma by CT and MRI with serum PRL>100ng/ml as clinical diagnostic criteria, they had the higher consistency with pathological diagnosis.We have to pay much more attention to the possibility of diagnose prolactinoma with serum PRL>100ng/ml. |
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