A Clinical Study About The Relationship Between Pituitary Apoplexy And Invasiveness Of Pituitary Tumor

Objective:To exploring the relationship between pituitary apoplexy and invasiveness of pituitary tumor by propensity score matching.Methods:In this retrospective study,patients were included who were diagnosed with pituitary tumor and hospitalized in the Department of Neurosurgery of Shanxi Provincial People’s Hospital from June 2017 to November 2020.The patients were divided into apoplexy and non-apoplexy groups according to whether the pituitary tumor had bleeding.The baseline data of the two groups were analyzed,and the confounding factors of the baseline data are avoided by propensity score matching.The two groups were matched at 1:1,and conditional logistic analysis was applied to exploring the relationship between pituitary apoplexy and invasiveness of the pituitary tumor.Results:A total of 570 patients with pituitary tumor were enrolled,100 cases(17.6%)with pituitary apoplexy,and 470 cases without apoplexy.Before matching,there were differences between the two groups in gender,age,and Knosp classification(P <0.05).There are more men than women in the apoplexy group(63% vs.37%).The proportion of apoplexy group in Knosp classification grade 3 and 4 was higher than that of nonapoplexy group(56% vs.34.1%).There was no statistical difference in baseline data between the two groups after matching.Compared with the non-apoplexy group,the apoplexy group showed more symptoms such as headache,nausea,ophthalmoplegia,and disturbance of consciousness(P<0.05),but there was no significant significance in symptoms such as galactorrhea and menstrual disorders in women(P>0.05).Conditional logistic regression was used to analyze the relationship between pituitary apoplexy and invasiveness.Pituitary tumor hemorrhage was significantly associated with the invasiveness of pituitary tumor(P=0.008),and no correlation with the size of a pituitary tumor(P=0.746).After removing pituitary tumor size,the P-value of pituitary tumor apoplexy and the invasiveness of pituitary tumor was 0.004,the difference was statistically significant.Knosp 3 is a risk factor for pituitary apoplexy among different Knosp grades,with a P =0.019.Conclusion:1.The clinical manifestations of pituitary apoplexy are more complicated than a pituitary tumor without apoplexy.Symptoms such as headache,nausea,dizziness,ocular palsy,decreased visual acuity,visual field defect,and disturbance of consciousness occur more frequently in patients with pituitary apoplexy.2.Invasive pituitary tumor are more prone to hemorrhage than pituitary tumor without cavernous sinus invasion.The size of the pituitary tumor does not affect apoplexy.3.Pituitary tumor with Knosp 3 grade are more prone to apoplexy than other grades.