Rieger A, Rainov N G, Ebel H, Sanchin L, Shibib K, Helfrich C, Hoffmann O, Burkert W
Neurosurgical Clinic, Medical Faculty, Martin-Luther-University, Halle/Saale, Fed. Rep. of Germany.
Neurosurg Rev. 1997;20(3):182-7. doi: 10.1007/BF01105562.
Forty-four adult acromegalic patients carrying growth hormone-producing pituitary macroadenomas were investigated with neuroradiological and endocrinological techniques. Plasma growth hormone and somatomedin-C levels were repeatedly measured before surgical removal of tumors and during the follow-up period. Twenty-five patients presented preoperatively with an invasive adenoma that involved the cavernous sinus (CS). Diagnosis of tumor invasivity was made according to distinct neuroradiological criteria and was confirmed or rejected during surgery Significantly higher basal growth hormone levels were found in patients with CS invasion than in cases without tumor growth in the CS. Evidence is presented that plasma growth hormone level in acromegalics is a more sensitive indicator for predicting tumor invasiveness than somatomedin-C. Growth hormone basal values before surgery and the extent of their decrease after removal of tumor correlate with adenoma growth in the parasellar compartments and should be used as a prognostic factor to aid in planing adjuvant tumor treatment.
对44例患有分泌生长激素的垂体大腺瘤的成年肢端肥大症患者采用神经放射学和内分泌学技术进行了研究。在手术切除肿瘤前及随访期间反复测量血浆生长激素和生长调节素C水平。25例患者术前表现为侵袭性腺瘤，累及海绵窦（CS）。根据明确的神经放射学标准做出肿瘤侵袭性诊断，并在手术中得到证实或排除。发现海绵窦侵袭患者的基础生长激素水平显著高于海绵窦无肿瘤生长的患者。有证据表明，肢端肥大症患者的血浆生长激素水平比生长调节素C更能敏感地预测肿瘤侵袭性。手术前生长激素基础值及其切除肿瘤后的下降程度与鞍旁间隙腺瘤生长相关，应用作预后因素以辅助规划辅助性肿瘤治疗。
