Bigos S T, Somma M, Rasio E, Eastman R C, Lanthier A, Johnston H H, Hardy J
J Clin Endocrinol Metab. 1980 Feb;50(2):348-54. doi: 10.1210/jcem-50-2-348.
Over 15 yr, 24 patients underwent transsphenoidal pituitary surgery for Cushing's disease with a median follow-up of 12 months. Cures included 7 patients with normal sella turcicas (6 microadenomas), 6 patients with focal depressions (6 microadenomas) of the sella (grade I), and 3 patients (3 adenomas) with enlarged sellas (grade II). Three patients with sella destruction (grades III and IV), 2 with normal sellas, and 1 with focal sella depression (grade I) were not cured. Two apparent cures (microadenomas) recurred. Tumor histology revealed 19 basophilic adenomas; electron microscopy (14 tumors) and immunochemical studies (10 tumors) revealed only ACTH cells. Circadian rhythm returned in 6 cured patients. Impotence (in 2), amenorrhea (in 7), and galactorrhea (in 3) resolved in affected cured patients. The major surgical complication was hemorrhage at the operative site (3 patients). Transsphenoidal pituitary surgery is a valuable method for managing Cushing's disease in many patients.
在15年多的时间里，24例患者因库欣病接受了经蝶窦垂体手术，中位随访时间为12个月。治愈的患者包括7例蝶鞍正常的患者（6例微腺瘤）、6例蝶鞍有局灶性凹陷的患者（6例微腺瘤，I级）以及3例蝶鞍增大的患者（3例腺瘤，II级）。3例蝶鞍破坏的患者（III级和IV级）、2例蝶鞍正常的患者以及1例蝶鞍有局灶性凹陷的患者（I级）未治愈。2例明显治愈的患者（微腺瘤）复发。肿瘤组织学检查显示19例嗜碱性腺瘤；电子显微镜检查（14例肿瘤）和免疫化学研究（10例肿瘤）仅发现促肾上腺皮质激素细胞。6例治愈患者的昼夜节律恢复正常。受影响的治愈患者中，阳痿（2例）、闭经（7例）和溢乳（3例）症状消失。主要的手术并发症是手术部位出血（3例患者）。经蝶窦垂体手术是治疗许多库欣病患者的一种有价值的方法。
