Knosp E, Krisch K, Schmidbauer M, Budka H
Neurochirurgische Universitätsklinik, Wien.
Wien Klin Wochenschr. 1988 May 13;100(10):322-5.
Forty-four out of 82 patients with neurosurgically removed pituitary adenomas showed preoperatively elevated plasma hormone levels of prolactin (PRL; 22 patients), of human growth hormone (hGH; 15 patients), and of adrenocorticotropic hormone (ACTH; 7 patients). Immunocytochemical detection of the hypersecreted hormone in paraffin sections of tumour tissue, was possible in all 7 patients (100%) with Cushing's disease, in 20 patients (90%) with hyperprolactinaemia, and in 10 patients (66%) with acromegaly. In a further 3 cases beta-TSH, in one case beta-LH, and in 8 cases alpha-HCG were demonstrated in sections of tumour tissue. No clinical evidence of endocrine disturbance was found in any of these latter cases. More than one anterior pituitary hormone was detected in sections of tumour tissue in 7 cases. An overall qualitative correlation of 85% was found between the elevated plasma hormone level and immunocytochemical hormone detection in tumour tissue sections. Since there is no correlation between conventional histological staining modalities (acidophilic, basophilic, chromophobic) on the one hand, and the level of plasma hormones or immunological hormone detection in tumour tissue on the other hand, modern histological diagnosis of a pituitary adenoma should include assessment of the functional state as found by immunocytochemical hormone determination.
82例经神经外科手术切除垂体腺瘤的患者中,44例术前血浆催乳素(PRL;22例)、人生长激素(hGH;15例)和促肾上腺皮质激素(ACTH;7例)水平升高。在肿瘤组织石蜡切片中,对所有7例库欣病患者(100%)、20例高催乳素血症患者(90%)和10例肢端肥大症患者(66%),均可通过免疫细胞化学检测到肿瘤组织中过度分泌的激素。在另外3例肿瘤组织切片中检测到β-促甲状腺激素,1例中检测到β-促黄体生成素,8例中检测到α-人绒毛膜促性腺激素。在上述所有这些病例中均未发现内分泌紊乱的临床证据。7例肿瘤组织切片中检测到不止一种垂体前叶激素。在肿瘤组织切片中,血浆激素水平升高与免疫细胞化学激素检测之间的总体定性相关性为85%。由于一方面传统组织学染色方式(嗜酸性、嗜碱性、嫌色性)与另一方面血浆激素水平或肿瘤组织中激素免疫检测之间不存在相关性,垂体腺瘤的现代组织学诊断应包括通过免疫细胞化学激素测定对功能状态的评估。