Maira G, Anile C, De Marinis L, Barbarino A
Institute of Neurosurgery, Catholic University, Rome, Italy.
Neurosurgery. 1989 May;24(5):736-43. doi: 10.1227/00006123-198905000-00013.
Transsphenoidal surgery is an efficacious treatment for patients with prolactin (PRL)-secreting adenomas, even if disrupted pituitary-hypothalamic relationships may persist and/or a recurrence of the PRL-secreting tumor can occur. In this paper, we analyze the long-term follow-up of 119 consecutively treated women who underwent transsphenoidal microsurgery for PRL-secreting adenomas. Apparent total removal of the tumor was achieved in 98 patients who had enclosed tumors (58 with Grade-I tumors and 40 with Grade II). In the remaining patients, the removal was considered partial. Persistent normal basal PRL levels were achieved in 61 patients who had apparent total removal of the adenoma (44 with Grade I tumors and 17 with Grade II). Of the remaining 37 patients in whom surgical removal of the adenomatous tissue was thought to be total, 30 had persistent nonevolutive, high PRL levels ranging from 21 to 196 ng/ml, without clinical and radiological signs of tumor regrowth, and 7 with PRL levels ranging from 56 to 560 ng/ml had a recurrence of the PRL-secreting tumor. These data seem to indicate that a slightly elevated postsurgical PRL value does not imply that tumoral tissue is still present. Nontumoral conditions (i.e., a secondary empty sella) could induce functional hyperprolactinemia.
经蝶窦手术是治疗泌乳素（PRL）分泌型腺瘤患者的一种有效方法，即便垂体 - 下丘脑关系紊乱可能持续存在和/或PRL分泌型肿瘤可能复发。在本文中，我们分析了119例连续接受经蝶窦显微手术治疗PRL分泌型腺瘤的女性患者的长期随访情况。98例肿瘤包膜完整的患者（58例为I级肿瘤，40例为II级肿瘤）实现了肿瘤的明显全切。其余患者的切除被认为是部分切除。61例腺瘤明显全切的患者（44例为I级肿瘤，17例为II级肿瘤）术后基础PRL水平持续正常。在其余37例手术切除腺瘤组织被认为是全切的患者中，30例PRL水平持续无变化且较高，范围为21至196 ng/ml，无肿瘤复发的临床和影像学征象，7例PRL水平范围为56至560 ng/ml的患者出现了PRL分泌型肿瘤复发。这些数据似乎表明，术后PRL值略有升高并不意味着仍存在肿瘤组织。非肿瘤性情况（即继发性空蝶鞍）可导致功能性高泌乳素血症。
