A Retrospective Analysis Of 264 Pituitary Adenoma Patients

Background Pituitary adenomas are monoclonal benign tumours arising from adenohypophyseal cells and account for 10–15% of all intracranial neoplasms. Their prevalence based on recent cross-sectional community-based studies is estimated at80–90 per 100,000. Although considered benign, as many as 25–55% of pituitary adenomas are invasive and some exhibit clinically aggressive behavior. Clinically, we found that such aggressive pituitary adenomas are more prone to recurrence, even after surgery, drugs, radiation therapy. Therefore, the early prediction of aggressive pituitary adenomas shows a great significance.Purposes To analyze clinical characteristics of pituitary adenoma. To explore the factors affecting pituitary adenoma tumor bed bleeding. To explore the factors affecting pituitary adenoma aggressive behavior.Methods Retrospectively analyze the medical records, imaging data and postoperative follow-up data of pituitary adenoma patients who were performed surgical operation in Capital Medical University Sanbo Brain Hospital from February2011 to October 2012 were collected to examine. Using Microsoft Excel to log,Collate data. Using SPSS17.0 statistical software to analyze data. statistical methods include rank sum test, chi-square test and binary Logistic regression.Results We collected 264 pituitary adenoma patients who were performed surgical treatment. There were 119 males and 145 females. They were all in 10-82 years old.The median age was 43 years old. There were 66% patients in the 31-60 years old.There are 36 cases of microadenoma(13.6%), 185 cases of large adenomas(70.1%),43 patients of giant adenoma(16.3%). According to clinical manifestation, serum hormone and pathological immunohistochemistry, that were divided into PRL pituitary adenoma(71 cases), GH adenoma( 34 cases), ACTH adenoma( 19 cases),TSH adenoma( 5 cases), FSH / LH adenoma(76 cases), non-functional adenoma( 45cases) and multiple hormone adenomas(14 cases). There were 7 patients suffering from tumor bed bleeding by CT. About 9.3% of the craniotomy bleed on tumor bed.Age and tumor size were associated with tumor bed bleeding, but there is no association with the extent of tumor resection. In the case of other factors constant,the greater age and the greater tumor volume, the risk of tumor bed bleeding was more higher. We followed up 186 patients. There were 11 cases aggressive pituitary adenomas of which 6 cases were invasive adenomas. Age, invasion, Ki-67 index,mitosis were associated with aggressive behavior(p < 0.05), but P53 was of no significant correlation(p>0.05). Age is protective factor of the aggressive behavior of pituitary adenoma. Pituitary adenoma with invasive growth, higher Ki-67 index and mitosis suggested higher risk of aggressive behavior.Conclusions Age and giant pituitary adenoma are risk factors of tumor bed bleeding. Age is a protective factor of aggressive behavior of pituitary adenoma.Pituitary adenoma with invasive growth, higher Ki-67 index and mitosis are risk factors of aggressive behavior,but P53 was of no significant correlation.