Analysis Of The Diagnostic Value Of Preoperative Inflammatory Index In Space-occupying Lesions Of Sellar Region

Objective: Pituitary adenoma is the most common benign tumor in sellar region and the third common intracranial tumor,which has been increasing in recent years.The objective of this study was to compare the levels of inflammatory markers in peripheral blood between different subtypes of pituitary adenoma and between pituitary adenoma and other sellar tumors before surgery,and to explore their differential diagnostic value.Methods: The clinical data(complete clinical data)of patients who were admitted to the Department of Neurosurgery,the First Hospital of Jilin University from August 2018 to the end of December 2022 and diagnosed as sellar mass by preoperative imaging,underwent surgical treatment and confirmed by pathology were retrospectively analyzed.Clinical data of the patients collected included: Gender,age,preoperative albumin,preoperative globulin,preoperative inflammatory indicators(including white blood cells,neutrophils,lymphocytes,monocytes,platelets,eosinophils,basophils,platelets,albumin,globulin,white/globulus,PLR,NLR,LMR,d NLR,PNI,SSI),history of diabetes,history of hypertension,blood History of fluid,heart disease,liver disease,kidney disease,autoimmune disease and other diseases,postoperative pathology,etc.SPSS 27.0 and Graph Pad Prism 8 were used for data processing and statistical analysis of each factor.Firstly,Kolmogorov-Smirnov test(sample size greater than 50)and Shapiro-Wilks test(sample size less than or equal to 50)were used to analyze the normal distribution of variables.Normally distributed data were analyzed by a two-tailed student’s t-test.For non-parametric data,the Mann-Whitney U test was used for comparison between groups.The diagnostic performance of the above specific inflammatory markers for sellar mass was evaluated by the area under the curve(AUC) obtained from the receiver operating characteristic(ROC)curve.A two-tailed p-value <0.05 was considered statistically significant.Results: In addition to the ACTH cell adenoma group and the plurihormonal cell adenoma group,some inflammatory markers were found in the other comparison groups,which may be used as indicators for the differentiation between tumors(P<0.5).The results showed that the mononuclear cell count of PRL cell adenoma group was the highest,which was higher than that of other pituitary adenoma subgroups,while the LMR level of GH cell adenoma group was higher than that of other pituitary adenoma subgroups.Compared with other sellar tumors,the mononuclear cell count was higher in the pituitary adenoma group,but the PNI level was higher in the craniopharyngioma group than in the other sellar tumors.The highest lymphocyte count was found in the sellar meningioma group.Conclusion: Inflammation is closely related to the occurrence and development of sellar tumors.Lymphocyte count,monocyte count and PNI can be used as one of the methods to distinguish pituitary adenoma,sellar meningioma,Rathke cyst and craniopharyngioma.Monocyte count and LMR levels were used as one of the means to distinguish between the subtypes of pituitary adenomas,provided that thyroid stimulating hormone(TSH)-secreting adenomas were excluded.