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[激素免疫组化阳性垂体腺瘤的侵袭性生长模式]

[Pattern of invasive growth of pituitary adenomas with positive hormonal immunohistochemistry].

作者信息

Bello-Lemus Victor Hugo, Torres-Zapiain Fernando, Murillo-Ortiz Blanca Olivia

机构信息

Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades, Unidad Médica de Alta Especialidad No. 1, Servicio de Neurocirugía. León, Guanajuato, México.

Instituto Mexicano del Seguro Social, Órganos de Operación Administrativa Desconcentrada Guanajuato, Unidad de Investigación en Epidemiología Clínica. León, Guanajuato, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2025 Mar 3;63(2):e6409. doi: 10.5281/zenodo.14617045.

Abstract

BACKGROUND

Pituitary adenoma is the most frequent tumor of the selar region, it is generally benign, however, invasive growth towards parasellar and/or suprasellar can affect important structures causing high morbimortality.

OBJECTIVE

To determine the invasive growth pattern of pituitary adenomas and its relationship with positive immunohistochemistry hormonal markers.

MATERIAL AND METHODS

In the period from March 2020 to March 2022, patients of both sexes, older than 18 years, with histopathological diagnosis of pituitary adenoma, with immunohistochemistry report and contrasted magnetic resonance imaging were included. They were classified into invasive and non-invasive according to Knosp and Hardy classifications by MRI and according to hormonal immunohistochemistry as positive or negative.

RESULTS

50 cases fulfilled the inclusion criteria. 28 adenomas (56%) with positive hormonal immunohistochemistry and 22 adenomas (46%) with negative hormonal immunohistochemistry. The invasive growth pattern was as follows 50% parasellar according to Knosp classification and 74% suprasellar according to Hardy classification. We did not observe any relationship between invasive behavior and positive hormonal immunohistochemistry.

CONCLUSIONS

The incidence of pituitary adenoma by sex and age was very similar to the international literature, being more frequent in females and by age between 30 and over 60 years. The most frequent invasive growth pattern was suprasellar by Hardy classification. We did not observe a significant relationship between supra or parasellar invasive growth pattern and positive hormonal immunohistochemistry. Interestingly, there is a significant relationship between non-invasion of the cavernous sinus and less recurrence.

摘要

背景

垂体腺瘤是鞍区最常见的肿瘤,通常为良性,然而,向鞍旁和/或鞍上的侵袭性生长可影响重要结构,导致高病残率和死亡率。

目的

确定垂体腺瘤的侵袭性生长模式及其与免疫组化激素阳性标志物的关系。

材料与方法

纳入2020年3月至2022年3月期间年龄大于18岁、经组织病理学诊断为垂体腺瘤、有免疫组化报告及对比增强磁共振成像的患者。根据MRI的Knosp和Hardy分类以及激素免疫组化结果将其分为侵袭性和非侵袭性,激素免疫组化结果分为阳性或阴性。

结果

50例符合纳入标准。28例腺瘤(56%)激素免疫组化阳性,22例腺瘤(46%)激素免疫组化阴性。侵袭性生长模式如下:根据Knosp分类,鞍旁侵袭占50%;根据Hardy分类,鞍上侵袭占74%。我们未观察到侵袭行为与激素免疫组化阳性之间存在任何关系。

结论

垂体腺瘤的性别和年龄发病率与国际文献非常相似,女性更为常见,年龄在30岁至60岁以上。根据Hardy分类,最常见的侵袭性生长模式是鞍上侵袭。我们未观察到鞍上或鞍旁侵袭性生长模式与激素免疫组化阳性之间存在显著关系。有趣的是,海绵窦无侵袭与复发较少之间存在显著关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22a3/12043349/e6f3ac5af84e/04435117-63-2-e6409-f001.jpg

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