Center for Pituitary Surgery, Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Histology and Embryology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China.
Front Endocrinol (Lausanne). 2021 Sep 30;12:748997. doi: 10.3389/fendo.2021.748997. eCollection 2021.
Currently, it is difficult to estimate the possibility of recurrence of nonfunctioning pituitary adenomas (NFPAs). Markers such as Ki-67 or transcription factors rely on postoperative pathology, while few indices can be used for preoperative prediction. Therefore, we aimed to investigate the predictive effectiveness of supra-intrasellar volume and tumor-carotid distance based on measurements derived from preoperative magnetic resonance imaging (MRI) data.
Ninety-eight cases of NFPAs were evaluated, along with their clinical characteristics and MRI features. Four radiologic indices were analyzed, including intrasellar tumor volume, suprasellar tumor volume, maximum horizontal tumor diameter, and intercarotid distance. The ratio of supra-intrasellar volume and ratio of tumor-carotid distance were measured using 3D Slicer software, and the sum of two ratios was defined as the V-D value. The correlation between recurrence and multiple factors was analyzed using univariate and multivariate logistic regression and Kaplan-Meier analysis, and ROC curves were used to estimate the prognostic performance of radiologic measurements in NFPAs.
The supra-intrasellar volume ratio, tumor-carotid distance ratio and V-D value were significantly correlated with the recurrence of NFPAs. The predictive importance of the V-D value reached 84.5%, with a sensitivity of 83.7% and specificity of 67.3%. The cutoff limit of the V-D value was 1.53, and patients with V-D values higher than 1.53 tended to relapse much earlier.
The V-D value has predictive importance for the recurrence of NFPAs preoperatively. Patients with higher V-D values will undergo recurrence earlier and should be given greater consideration in terms of surgery and follow-up time.
目前，预测无功能垂体腺瘤（NFPAs）复发的可能性较为困难。Ki-67 或转录因子等标志物依赖于术后病理，而术前预测的指标较少。因此，我们旨在研究基于术前磁共振成像（MRI）数据得出的鞍上-鞍内体积比和肿瘤-颈内动脉距离的预测效果。
评估了 98 例 NFPAs 患者的临床特征和 MRI 特征。分析了 4 个影像学指标，包括鞍内肿瘤体积、鞍上肿瘤体积、最大水平肿瘤直径和颈内动脉距离。使用 3D Slicer 软件测量了超-鞍内体积比和肿瘤-颈内动脉距离比，将两个比值的和定义为 V-D 值。使用单变量和多变量逻辑回归以及 Kaplan-Meier 分析分析复发与多种因素的相关性，并使用 ROC 曲线估计影像学测量在 NFPAs 中的预后性能。
超-鞍内体积比、肿瘤-颈内动脉距离比和 V-D 值与 NFPAs 的复发显著相关。V-D 值的预测重要性达到 84.5%，其灵敏度为 83.7%，特异性为 67.3%。V-D 值的截断值为 1.53，V-D 值高于 1.53 的患者复发较早。
V-D 值对 NFPAs 的术前复发具有预测重要性。V-D 值较高的患者会较早复发，在手术和随访时间方面应给予更多考虑。
