Effect Of Combined Treatment On Invasive Pituitary Adenoma In 58 Patients And Relationship Between The Expression Of Ki-67 Antigen And Invasiveness In The Pituitary Adenoma

Objective: Disscuss the strategies of therapeutic methods of invasive pituitary adenomas, the relationship between the expression of Ki-67 angtigen and invasiveness of the tumors, in order to improve the therapeutic efficacies. Methods: Retrospectively study the data from a series of 58 patients consistent with diagnostic criteria of invasive pituitary adenoma that admitted in our department from 1, 2003-11, 2006, analysis data of the clinical situation, common operative approach, imageology and pathological, treatments of postoperative complications, Gamma Knife treatment; Study the expression of Ki-67 between invasive pituitary adenoma and non-invasive groups by immunochemistry. Results: The patients in the group were followed ranging from 5 months to 35 months(mean 11 months). There were 5 patient relapsed after the operation, and no surgical mortality. As to the result of supplementary Gamma Knife treatment, there were 38 patients followed 11 months, without severe decrease or loss of visual acuity and no mortality. The residual tumors were diminished in volume demonstrated in the MRI 3-8 moths after the treatment. The expressions of Ki-67 were significantly higher in invasive group than that of non-invasive adenomas (p＜0.05). Conclusion: Transsphenoidal, pterion, and subfrontal approach have still been three of classical operation approachs. The index of Ki-67 in Pituitary adenoma can reflect cytologically the proliferation and invasiveness of the tumor cell, suggesting that it may served as an clinical index for evaluating the tumor recurrence and a guidance for postoperative treatment. Gamma-knife is an effective treatment with few complications, which can be used as supplementary measure.