垂体生长激素腺瘤术前药物治疗及经蝶手术近期疗效的影响因素分析

摘要

目的：分析垂体生长激素腺瘤术前药物及经蝶手术近期疗效的影响因素。方法：回顾分析53例药物、手术联合治疗的垂体生长激素腺瘤患者资料，分析术前药物治疗效果及术后缓解率的影响因素。结果：术前药物治疗后62．26％的患者生长激素抑制率＜50．00％，χ2检验提示性别、病理类型、肿瘤体积及侵袭性4项因素差异均无统计学意义。全组病例总体缓解率为43．40％，χ2检验提示性别及病理类型2项因素差异无统计学意义，术前药物疗效、肿瘤体积及侵袭性3项因素差异存在统计学意义。 Logistic 回归分析提示肿瘤体积及侵袭性2项因素差异存在统计学意义，术前药物疗效差异无统计学意义。结论：术前药物疗效与性别、病理类型、肿瘤体积及侵袭性无明显相关性；与术前药物疗效不佳病例相比，疗效较好病例术后缓解率存在差异。但就本组病例而言，尚不能认为术前药物疗效是术后缓解率的影响因素；肿瘤体积及侵袭性是术后缓解率的影响因素。%Objective To analyze factors influencing short-term effect of presurgical pharmacological thera-py and transsphenoidal microsurgery for somatotropinomas. Methods The clinical data of 53 patients underwent presurgical pharmacological therapy and transsphenoidal surgery for somatotropinomas were retrospectively analyzed in order to search for factors influencing effect of presurgical pharmacological therapy and transsphenoidal surgery for somatotropinomas. Results Serum GH inhibition rates decreased<50.00%from baseline in 62.26%of patients receiving presurgical pharmacological therapy. Statistical analysis concerning the influence of sex , neuropathological evaluation, tumor size and presence of invasion on presurgical pharmacological therapy effect were performed using a chi-squared test, no significant correlation was found among these factors and presurgical pharmacological therapy effect. Total remission rates were 43.40%, Statistical analysis concerning the influence of sex , neuropathological e valuation, tumor size, presence of invasion and presurgical pharmacological therapy effect on remission rate were performed using a chi-squared test, a significant correlation was found among tumor size, presence of invasion, presurgical pharmacological therapy effect and remission rate , while no significant correlation was found among the rest of the factors. Further Logistic regression analysis demonstrated a significant correlation among tumor size , presence of invasion and remission rate , while no significant correlation was found between presurgical pharmacolog-ical therapy effect and remission rate. Conclusions Presurgical pharmacological therapy effect revealed no signifi-cant correlation with sex, neuropathological evaluation, tumor size or presence of invasion. Total remission rate cor-related with tumor size and presence of invasion. A better presurgical pharmacological therapy effect may indicated a better outcome, while postoperative remission rate revealed no significant correlation with presurgical pharmacologi-cal therapy in our series.