1Division of Endocrinology and Metabolism,Dalhousie University,Halifax,Nova Scotia,Canada.
2Department of Diagnostic Radiology,Division of Neuroradiology,Dalhousie University,QEII Health Sciences Centre,Halifax,Nova Scotia,Canada.
Can J Neurol Sci. 2017 Sep;44(5):508-513. doi: 10.1017/cjn.2017.203. Epub 2017 Jul 3.
To compare growth patterns of nonfunctioning and prolactin-producing pituitary macroadenomas, and to find whether their specific growth patterns are associated with clinically significant effects on vision.
From our comprehensive provincial neuropituitary registry, we retrospectively identified 35 randomly selected patients each with nonfunctioning adenomas and prolactinomas >10 mm in any dimension. MRI scans were analyzed to determine the superior and inferior growth, volume, and maximum craniocaudal height of the adenomas. Patients underwent visual field testing at diagnosis. Continuous variables were compared using Student's t test, the Mann-Whitney U test, and ANOVA. Categorical variables were compared using the chi-square test.
The mean height of prolactinomas (23.2±11.3 mm) was similar to nonfunctioning adenomas (22.3±9.3 mm, p=0.8), and so were mean tumor volumes (prolactinoma=5.9±8 ml vs. nonfunctioning adenoma=4.8±5 ml, p=0.47). However, the mean suprasellar growth for prolactinomas was 2.9±5.3 mm and 7.3±4.7 mm for nonfunctioning adenomas (p<0.001), and the mean infrasellar growth was 10.2±8.0 and 5.0±6.6 mm, respectively (p=0.04). The inferior growth pattern of prolactinomas was associated with a significantly lower likelihood of having visual field abnormalities (11.4 vs. 57.1%, p<0.001).
Prolactinomas have predominantly inferior growth compared to nonfunctioning adenomas and are less likely to cause vision changes.
比较无功能和泌乳素型垂体大腺瘤的生长模式，并确定其特定的生长模式是否与对视功能产生显著影响相关。
我们从综合性省级神经垂体登记处中，回顾性地选择了 35 名患者，每位患者的无功能腺瘤和任何径线>10mm 的泌乳素瘤随机入选。对 MRI 扫描进行分析，以确定肿瘤的上下生长、体积和最大颅尾高度。患者在诊断时接受了视野检查。使用学生 t 检验、Mann-Whitney U 检验和 ANOVA 比较连续变量，使用卡方检验比较分类变量。
泌乳素瘤的平均高度（23.2±11.3mm）与无功能腺瘤相似（22.3±9.3mm，p=0.8），平均肿瘤体积也相似（泌乳素瘤=5.9±8ml 比无功能腺瘤=4.8±5ml，p=0.47）。然而，泌乳素瘤的鞍上生长平均值为 2.9±5.3mm，无功能腺瘤为 7.3±4.7mm（p<0.001），鞍下生长平均值分别为 10.2±8.0mm 和 5.0±6.6mm（p=0.04）。泌乳素瘤的下生长模式与视野异常的发生几率明显降低相关（11.4%比 57.1%，p<0.001）。
与无功能腺瘤相比，泌乳素瘤主要呈下生长，且对视功能改变的发生可能性较小。
