501例垂体瘤患者临床特征及预后分析

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[目的]探讨垂体瘤患者的临床特征和预后分析。[方法]对2006年1月至2015年12月就诊于襄阳市中心医院的501例垂体瘤术后患者的临床资料进行回顾性分析。[结果 ]男性患者的发病年龄明显高于女性(46.7±13.2岁vs 45.0±12.5岁;t=2.994,P=0.003)。肿瘤大小0.5~8.0cm。其中大腺瘤最为多见(86.0%),其次为巨大腺瘤(8.6%),而微腺瘤的检出率仅为5.4%;不同影像学检查方法与不同大小垂体瘤检出率之间差异有统计学意义(χ2=7.085,P=0.029)。MRI对微腺瘤的检出率(77.8%)高于CT的检出率(22.2%)。垂体瘤临床症状以头晕、头痛及呕吐为主(46.1%),其次为视力下降、视物模糊、视野缺损(35.7%)。术前诊断以多激素混合瘤最多(60.1%),其次为促甲状腺激素瘤(TSH)(16.6%),促性腺激素瘤(LH/FSH)最低(0.6%),术后病理诊断以泌乳素瘤(PRL)最多(33.1%),其次为多激素混合瘤(21.6%)。生存分析结果显示,患者10年总体生存率为70.27%,其中,无功能性腺瘤与功能性腺瘤的10年生存率分别为66.72%与75.31%。[结论 ]垂体瘤多发于41~70岁人群,以大腺瘤最为多见,MRI对微腺瘤的检出率高于CT。患者术后生存情况相对较好,其中功能性腺瘤患者的生存情况优于无功能性腺瘤患者,应加大对无功能腺瘤患者的临床关注。 [Objective] To investigate the clinical features and prognosis of pituitary adenomas. [Methods] The clinical data of 501 patients with pituitary tumor who were treated in Xiangyang Central Hospital from January 2006 to December 2015 were analyzed retrospectively. [Results] The incidence of male patients was significantly higher than that of women (46.7 ± 13.2 vs 45.0 ± 12.5 years; t = 2.994, P = 0.003). Tumor size 0.5 ~ 8.0cm. Among them, adenoma was the most common (86.0%), followed by giant adenoma (8.6%), while the detection rate of microadenoma was only 5.4%. Between different imaging methods and the detection rate of pituitary tumors of different sizes The difference was statistically significant (χ2 = 7.085, P = 0.029). The detection rate of micro adenoma by MRI (77.8%) was higher than that of CT (22.2%). The main clinical symptoms of pituitary tumor were dizziness, headache and vomiting (46.1%), followed by decreased visual acuity, blurred vision and visual field defect (35.7%). Preoperative diagnosis of multi-hormone mixed tumor up to (60.1%), followed by thyroid-stimulating thyroid tumor (TSH) (16.6%), gonadotropin (LH / FSH) lowest (0.6%), postoperative pathological diagnosis of prolactin The tumor (PRL) was the most (33.1%), followed by the polytope mixed tumor (21.6%). Survival analysis showed that the 10-year overall survival rate was 70.27%. The 10-year survival rates of non-functioning adenomas and functional adenomas were 66.72% and 75.31%, respectively. [Conclusion] Pituitary adenomas are frequently found in people aged 41-70 years old, most often with large adenomas, and the detection rate of microadenomas by MRI is higher than that of CT. Survival of patients after surgery is relatively good, in which patients with functional adenoma survival better than non-functional adenoma patients should be increased in patients with non-functional adenoma clinical focus.
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